Stress Detection Based on Sympathovagal Balance

ABSTRACT

A method for determining a stress level of a user based on a sympathovagal balance (SVB) value calculated based on a set of measurement data may include determining a heart-rate variability (HRV) characteristic as a ratio involving a number of autonomic nervous system (ANS) activity markers within a first portion of the set of measurement data and the number of ANS activity markers within a second portion of the set of measurement data, and then determining the stress level of the user based on the HRV characteristic. The first and second portions of the set of measurement data may be selected based on a user-specific baseline SVB value that divides a histogram representation of the set of measurement data into the first and second portions.

RELATED APPLICATION

This application claims the benefit, under 35 U.S.C. §119(e), of U.S.Provisional Patent Application No. 62/202,153 filed 6 Aug. 2015, titled“Methods and Systems for Stress Detection,” U.S. Provisional PatentApplication No. 62/202,135 filed 6 Aug. 2015, titled “ImprovingPerformance of Biological Measurements in Presence of Noise,” U.S.Provisional Patent Application No. 62/202,685 filed 7 Aug. 2015, titled“Continuous Stress Measurement with Built-in Alarm Fatigue ProofFeatures,” and U.S. Provisional Patent Application No. 62/193,509 filed16 Jul. 2015, titled “Approaches to Understand Stress-DeterminedBaseline Contexts and Stress Coping Capacity,” each of which isincorporated herein by reference.

TECHNICAL FIELD

This disclosure generally relates to improving usage and content forwearable electronic devices.

BACKGROUND

Mobile electronic devices provide a user with access to computingcapabilities even as the user moves about various locations. Examples ofmobile electronic devices include mobile phones, media players, laptops,tablets, personal digital assistants (PDAs), or hybrid devices thatinclude functionality of multiple devices of this type.

Mobile electronic devices may be part of a communication network such asa local area network, wide area network, cellular network, the Internet,or any other suitable network. A mobile electronic device may use acommunication network to communicate with other electronic devices, forexample, to access remotely-stored data, access remote processing power,access remote displays, provide locally-stored data, provide localprocessing power, or provide access to local displays. For example,networks may provide communication paths and links to servers, which mayhost applications, content, and services that may be accessed orutilized by users via mobile electronic devices. The content may includetext, video data, audio data, user settings or other types of data.Networks may use any suitable communication protocol or technology tofacilitate communication between mobile electronic devices, such as, forexample, BLUETOOTH, IEEE WI-FI (802.11a/b/g/n/ac), or TransmissionControl Protocol/Internet Protocol (TCP/IP).

SUMMARY OF PARTICULAR EMBODIMENTS

In particular embodiments, a method for determining a stress level of auser based on a sympathovagal balance (SVB) value calculated based on aset of measurement data may include determining a heart-rate variability(HRV) characteristic as a ratio involving a number of autonomic nervoussystem (ANS) activity markers within a first portion of the set ofmeasurement data and the number of ANS activity markers within a secondportion of the set of measurement data, and then determining the stresslevel of the user based on the HRV characteristic. The first and secondportions of the set of measurement data may be selected based on auser-specific baseline SVB value that divides a histogram representationof the set of measurement data into the first and second portions.

In particular embodiments, a method for determining a HRV measurement ofa user may include receiving, from a sensor of an electronic device ofthe user, heart sensor data, determining a noise level of the heartsensor data, and then adjusting the HRV measurement by an amountcalculated based on the determined noise level. The sensor data mayinclude data on a photoplethysmograph (PPG) signal over anoise-calculation time period.

In particular embodiments, a method for monitoring a stress level of auser may include determining, based on biological measurements on one ormore physiological markers received in a first sampling mode, the stresslevel of the user, and then dynamically switching to a second samplingmode when it is determined that one or more of the physiological markersare above a threshold level, the second sampling mode being differentfrom the first sampling mode.

In particular embodiments, a method for monitoring a healthcharacteristic of a user based on one or more biological measurementsmay include selecting a context from a plurality of contexts, eachcontext corresponding to a baseline health value, and each context beingdefined by a plurality of recorded events each comprising one or more ofrepeated biological states, repeated user activity, or space-timecoordinates of the user, and then monitoring the health characteristicof the user based on one or more bio-sensing measurements in comparisonto the baseline health value corresponding to the selected context.

The embodiments disclosed above are only examples, and the scope of thisdisclosure is not limited to them. Particular embodiments may includeall, some, or none of the components, elements, features, functions,operations, or steps of the embodiments disclosed above. Embodimentsaccording to the invention are in particular disclosed in the attachedclaims directed to a method, a storage medium, a system and a computerprogram product, wherein any feature mentioned in one claim category,e.g. method, can be claimed in another claim category, e.g. system, aswell. The dependencies or references back in the attached claims arechosen for formal reasons only. However any subject matter resultingfrom a deliberate reference back to any previous claims (in particularmultiple dependencies) can be claimed as well, so that any combinationof claims and the features thereof are disclosed and can be claimedregardless of the dependencies chosen in the attached claims. Thesubject-matter which can be claimed comprises not only the combinationsof features as set out in the attached claims but also any othercombination of features in the claims, wherein each feature mentioned inthe claims can be combined with any other feature or combination ofother features in the claims. Furthermore, any of the embodiments andfeatures described or depicted herein can be claimed in a separate claimand/or in any combination with any embodiment or feature described ordepicted herein or with any of the features of the attached claims.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates an example network environment for particularembodiments of an optical detection system for internal body tissues andbone.

FIG. 2A illustrates an example health monitoring system includingsystems and devices according to particular embodiments, and FIG. 2Billustrates another example health monitoring system including systemsand devices according to particular embodiments.

FIG. 3 illustrates an example mobile client.

FIGS. 4A and 4B illustrate example user interfaces according toparticular embodiments of the invention.

FIG. 5A illustrates an example of a baseline data histogram. FIG. 5Billustrates an example of a test data histogram in which a sympathovagalbalance is shifted to the left, and FIG. 5C illustrates an example of atest data histogram in which a sympathovagal balance is shifted to theright.

FIG. 6 illustrates an example method for stress detection.

FIG. 7A illustrates a probabilistic approach for low noise in the datameasurements, and FIG. 7B illustrates a probabilistic approach for highnoise in the data measurements. FIG. 7C illustrates a probabilisticapproach for updating a baseline SVB based on a probabilisticdetermination. FIG. 7D illustrates a graph that shows a range of stressvalues over time for a user.

FIG. 8 illustrates an example of a histogram exhibiting left shift froma baseline state.

FIG. 9 illustrates an example method for computing health measurementsusing noisy sensors.

FIG. 10 illustrates a noise compensation system for computing healthmeasurements using noisy sensors.

FIG. 11 illustrates an example method for determining ahealth-variability measurement of a user.

FIGS. 12A and 12B illustrate examples of heart-rate variability (HRV)measurement noise compensation results.

FIG. 13 illustrates an example use of an algorithm according toparticular embodiments of this invention.

FIGS. 14A-C illustrate a noise correction system for noise predictionand signal stitching or replacement.

FIG. 15 illustrates an example signal according to particularembodiments of this invention.

FIG. 16 illustrates an example method for detecting and analyzing signalfeatures based on particular embodiments of this invention.

FIG. 17 illustrates an example general method for continuous andpower-efficient monitoring of a user's stress level based on biologicalmeasurements of the user.

FIG. 18 illustrates an example method for reducing alarm fatigue usinghealth monitoring system.

FIG. 19 illustrates an example method for power-efficient monitoringusing health monitoring system.

FIG. 20 illustrates example software and hardware components of healthmonitoring system.

FIG. 21 illustrates an example method for generating and/or updatingcontext records of a user.

FIG. 22 illustrates an example method for generating a healthcharacteristic output for the user.

FIG. 23 illustrates an example method for determining a user's emotionalhealth based on a health-resiliency measurement.

FIG. 24 illustrates an example computer system according to particularembodiments of the invention.

DESCRIPTION OF EXAMPLE EMBODIMENTS System Overview

FIG. 1 illustrates an example network environment 100 for particularembodiments of a health monitoring system. Network environment 100includes a user 110, a client system 120, a network 130, one or moreservers 140, and one or more data stores 150. User 110, client system120, servers 140, and data stores 150 may be connected to each other bynetwork 130 via links 160. Although FIG. 1 illustrates a particulararrangement of user 110, client system 120, network 130, servers 140,and data stores 150, this disclosure contemplates any suitablearrangement of user 110, client system 120, network 130, servers 140,and data stores 150. As an example and not by way of limitation, two ormore of client system 120, servers 140, and data stores 150 may beconnected to each other directly, bypassing network 130. As anotherexample, two or more of client system 120, servers 140, and data stores150 may be physically or logically co-located with each other in wholeor in part. Moreover, although FIG. 1 illustrates a particular number ofuser 110, client system 120, network 130, servers 140, and data stores150, this disclosure contemplates any suitable number of user 110,client system 120, network 130, servers 140, and data stores 150. As anexample and not by way of limitation, network environment 100 mayinclude multiple users 110, client systems 120, networks 130, servers140, and data stores 150.

In particular embodiments, user 110 may be an individual (e.g., humanuser), an entity (e.g., an enterprise, business, or third-partyapplication), or a group (e.g., of individuals or entities) thatinteracts or communicates with client system 120. In particularembodiments, client system 120 may be any suitable computing device,such as, for example, a wearable computing device, a mobile computingdevice, a smartphone, a cellular telephone, a tablet computer, a laptopcomputer, a personal computer, an augmented/virtual reality device, orany combination thereof. User 110 may interact with one or more of thesedevices. In addition, these devices may communicate with each other vianetwork 130, directly (e.g., by non-network connections), by any othersuitable methods, or any combination thereof. As an example and not byway of limitation, the devices of client system 120 may communicate withnetwork 130 via a wireless communications protocol, such as Wi-Fi orBLUETOOTH. In particular embodiments, client system 120 may include aweb browser, such as MICROSOFT INTERNET EXPLORER, GOOGLE CHROME orMOZILLA FIREFOX, and may have one or more add-ons, plug-ins, or otherextensions, such as TOOLBAR or YAHOO TOOLBAR. A user at client system120 may enter a Uniform Resource Locator (URL) or other addressdirecting the web browser to a particular server (such as server 140),and the web browser may generate a Hyper Text Transfer Protocol (HTTP)request and communicate the HTTP request to server. The server mayaccept the HTTP request and communicate to client system 120 one or moreHyper Text Markup Language (HTML) files responsive to the HTTP request.Client system 120 may render a webpage based on the HTML files from theserver for presentation to the user. This disclosure contemplates anysuitable webpage files. As an example and not by way of limitation,webpages may render from HTML files, Extensible Hyper Text MarkupLanguage (XHTML) files, or Extensible Markup Language (XML) files,according to particular needs. Such pages may also execute scripts suchas, for example and without limitation, those written in JAVASCRIPT,JAVA, MICROSOFT SILVERLIGHT, combinations of markup language and scriptssuch as AJAX (Asynchronous JAVASCRIPT and XML), and the like. Herein,reference to a webpage encompasses one or more corresponding webpagefiles (which a browser may use to render the webpage) and vice versa,where appropriate.

In particular embodiments, network 130 may be any suitable network. Asan example and not by way of limitation, one or more portions of network130 may include an ad hoc network, an intranet, an extranet, a virtualprivate network (VPN), a local area network (LAN), a wireless LAN(WLAN), a wide area network (WAN), a wireless WAN (WWAN), a metropolitanarea network (MAN), a portion of the Internet, a portion of the PublicSwitched Telephone Network (PSTN), a cellular telephone network, or acombination of two or more of these. Network 130 may include one or morenetworks.

In particular embodiments, links 160 may connect client system 120,servers 140, and data stores 150 to network 130 or to each other. Thisdisclosure contemplates any suitable links 160. In particularembodiments, one or more links 160 include one or more wireline (such asfor example Digital Subscriber Line (DSL) or Data Over Cable ServiceInterface Specification (DOCSIS)), wireless (such as for example Wi-Fior Worldwide Interoperability for Microwave Access (WiMAX)), or optical(such as for example Synchronous Optical Network (SONET) or SynchronousDigital Hierarchy (SDH)) links. In particular embodiments, one or morelinks 160 each include an ad hoc network, an intranet, an extranet, aVPN, a LAN, a WLAN, a WAN, a WWAN, a MAN, a portion of the Internet, aportion of the PSTN, a cellular technology-based network, a satellitecommunications technology-based network, another link 160, or acombination of two or more such links 160. Links 160 need notnecessarily be the same throughout network environment 100. One or morefirst links 160 may differ in one or more respects from one or moresecond links 160.

In particular embodiments, servers 140 may be any suitable servers. Eachserver 140 may be a unitary server or a distributed server spanningmultiple computers or multiple datacenters. Servers 140 may be ofvarious types, such as, for example and without limitation, web server,file server, application server, exchange server, database server, proxyserver, another server suitable for performing functions or processesdescribed herein, or any combination thereof. In particular embodiments,each server 140 may include hardware, software, or embedded logiccomponents or a combination of two or more such components for carryingout the appropriate functionalities implemented or supported by server140.

In particular embodiments, data stores 150 may be any suitable datastores. Data stores 150 may be used to store various types ofinformation. In particular embodiments, the information stored in datastores 150 may be organized according to specific data structures. Inparticular embodiments, each data store 150 may be a relational,columnar, correlation, or other suitable database. Data store 150 mayinclude networked storage such as cloud storage or other networkaccessible storage. Additionally or alternatively, data store 150 mayinclude local storage within or directly attached to any of the devicesof client system 120, such as solid state drives (“SSDs”) or hard diskdrives (“HDDs”). Although this disclosure describes or illustratesparticular types of components and uses of these component of networkenvironment 100, this disclosure contemplates any suitable types ofcomponents, any suitable network topology (e.g., including astandalone-device topology), and any suitable uses for these componentsof network environment 100.

Health Monitoring and Applications Overview

Stress is considered to be one of the largest contributors to varioushealth problems, and is estimated to be a contributory factor in morethan 80% of all diseases. Particular embodiment discussed below focus onthe measurement of stress in the context of mobile monitoring andmanagement of health and/or wellness. In mobile monitoring andmanagement, use of wearable sensors can be a key new technology for usein the analysis and management of stress and other physiologicalcharacteristics because this management can be a bridge to themanagement of a wide variety of health problems including diabetes,hypertension, cardiovascular diseases, pulmonary diseases, mooddisorder, substance-abuse, overall quality of life, etc. The globalwearable device market is a rapidly-growing market as wearabletechnology becomes an integral part of the Internet of Things in which anetwork of physical objects/things embedded with electronics, software,sensors, and network connectivity enables these objects/things tocommunicate with one another and collect and exchange data with oneanother.

Stress management techniques may work by measuring theactivities/arousal of the autonomic nervous system (ANS), where higharousal is considered a sign of stress. For example, the arousal of ANSleads to changes in the physiology that may be easily measured viachanges in heart rate, skin conductance, blood pressure, respiration,brain wave patterns via electroencephalography (EEG), other relevantmetrics, or any combination thereof. Stress measurement techniques mayrely on measurement of heart-rate variability (HRV). Measurements of HRVmay be based on time-domain analysis or frequency-domain analysis, whichboth have numerous shortcomings.

As an example, frequency-domain analysis methods such as those based onfast Fourier transform (FFT), are not very suitable for implementationon mobile platforms since they are extremely sensitive to noiseartifacts, and may require long measurement time periods. Time domainmethods, such as root mean square of successive heartbeat intervaldifferences (RMSSD), standard deviation of NN (beat-to-beat) intervals(SDNN), and the proportion of the number of pairs of successive NNs thatare different by more than 50 millisecond divided by the total number ofNNs (pNN50), are frequently used to analyze the instantaneous heart-ratesignal. However, these methods may be inaccurate and instable, and thisinstability may become pronounced in the presence of noise, which is aphenomenon in a number of use models, such as in the context of wearablesensors. In addition, measurement of stress is, in a number of cases,meaningful only in the context of chronic and prolonged stress as shortterm spikes in stress, unless extremely sharp and unusual, are not verymeaningful to alert the user about. Moreover, such methods may quantifystress without considering the context of the measurement or thebaseline of the given user. As such, the methods may provide informationthat does not capture the true picture of the user's emotional health,and therefore the information provided by these methods is significantlyless actionable.

In addition, applications of technologies for quantifying HRV may behampered by a host of limitations that together make them impracticaland difficult for mass adoption/implementation. For example, thesetechnologies are based on weak and practically ineffective stressdetection methods. In addition, these technologies are not focused onthe relevant psychophysiological problems (acute and prolonged stress).Moreover, these technologies are not noise resilient and do not allowfor any compensation of noise. The measurement of stress helps provide ameasurement of emotional health which may then lead to stress managementand modulation through a variety of approaches. However, thesetechnologies may be fairly weak in creating a good marker of theemotional health (e.g., stress resilience). Lastly, the existingapplications are very power hungry and difficult to implement in contextof prolong, around-the-clock stress monitoring.

Particular embodiments described below address the inadequacies of theexisting methods by providing a holistic suite of interactive featuresfor measuring and monitoring various user-health indicators andproviding useful and actionable feedback to the user. For example,particular embodiments described below are directed to systems andmethods for stress monitoring and measurement that include a linear,ratio-based, and psychophysiological-measurement-based calculationdetermined from an analysis of sympathovagal balance (SVB) that treatsthe sympathetic nervous system (SNS) and parasympathetic nervous system(PSNS) with equal weightage. This SVB measurement has been determined tobe both highly sensitive as well as specific in detecting mental statesand stress levels of users, in addition to having a wide range ofapplicability to various other health measurements.

In addition, particular embodiments described below are directed tosystems and methods for sampling and power efficiency in maintainingdata-gathering sensors as on for only limited time periods necessary fordetermining various health measurements (e.g., to detect the onset ofstress via heart rate measurements). Furthermore, particular embodimentsdescribed below are directed to systems and methods for providing theuser with accurate data while not inundating the user with health-eventand/or stress onset messages, in addition to lower false alarms. As anexample, the user is only notified of highly harmful health eventsand/or stress events, which helps avoid alarm fatigue.

In addition, particular embodiments described below are directed tosystems and methods for obtaining data and providing user feedback in anindividualized, contextualized, and normalized manner. For example,health measurement baselines may be determined in an individualizedbasis for each user, and the health measurement data may be analyzedbased on a user-specific context and normalized for all users to providea meaningful measurement as feedback to the user. Furthermore, in theexample of measuring stress, particular embodiments described below aredirected to systems and methods for analyzing and monitoring not juststress, but also stress resilience as a marker of the user's stresscoping skill. Also, particular embodiments described below are directedto systems and methods that allow for customizable refinement of thecollected data to provide more use and insights for the user and/orother third parties (e.g., medical professionals).

In addition, particular embodiments described below are directed tosystems and methods for improving the collection of health data byimproving the performance of certain health measurements in the presentof noise by signal correction techniques, including improving noiseresiliency and providing noise-signal substitution in the presence of ahigh level of noise. Furthermore, particular embodiments described beloware directed to systems and methods for compensating for the effects ofnoise by determining the range of likely errors due to noise, inaddition to computing the displaying the extent of the noise to the userso that the user can understand the reliability of the measurements.

In particular embodiments, a method for determining a stress level of auser may be based on a SVB value calculated based on a set ofmeasurement data, as discussed in detail below. The method may includedetermining a HRV characteristic as a ratio involving a number of ANSactivity markers within a first portion of the set of measurement dataand the number of ANS activity markers within a second portion of theset of measurement data, and then determining the stress level of theuser based on the HRV characteristic. The first and second portions ofthe set of measurement data may be selected based on a user-specificbaseline SVB value that divides a histogram representation of the set ofmeasurement data into the first and second portions.

In particular embodiments, a method may determine a HRV measurement of auser in the presence of noise, and then detect and correct for thenoise, as discussed in detail below. The method may include receiving,from a sensor of an electronic device of the user, sensor data,determining a noise level of the sensor data, and then adjusting the HRVmeasurement by an amount calculated based on the determined noise level.The sensor data may include data on a PPG signal over anoise-calculation time period.

In particular embodiments, a method may monitor a stress level of a userin a continuous manner while reducing alarm fatigue, as discussed indetail below. The method may include determining, based on biologicalmeasurements on one or more physiological markers received in a firstsampling mode, the stress level of the user, and then dynamicallyswitching to a second sampling mode when it is determined that one ormore of the physiological markers are above a threshold level, thesecond sampling mode being different from the first sampling mode.

In particular embodiments, a method may monitor a health characteristicof a user based on one or more biological measurements to determine oneor more contexts (e.g., a baseline context, other relevant contexts,etc.) associated with the measurements, as discussed in detail below.The method may include selecting a context from a plurality of contexts,each context corresponding to a baseline health value, and each contextbeing defined by a plurality of recorded events each comprising one ormore of repeated biological states, repeated user activity, orspace-time coordinates of the user, and then monitoring the healthcharacteristic of the user based on one or more bio-sensing measurementsin comparison to the baseline health value corresponding to the selectedcontext.

Example Embodiments of Health Monitoring Systems and User Interfaces

FIG. 2A illustrates an example health monitoring system 200 includingsystems and devices according to particular embodiments, and FIG. 2Billustrates another example health monitoring system 270 includingsystems and devices according to particular embodiments. In particularembodiments, as shown in FIG. 2A, health monitoring system 200 mayinclude a health monitoring device 210 (e.g., positioned on user wrist220) and a mobile electronic device 230. Health monitoring device 210may be a wearable electronic device (e.g., a device of client system120) that can be worn on a portion of the user's body, such as an arm,wrist, finger, leg, ankle, toe, torso, neck, head, any other suitableportion of the body, or any combination thereof Health monitoring device210 may include a user interface 240, which may include a watch-likeuser interface in addition to one or more applications 250 (e.g., aweather application, an exercise application, a chat application, etc.).In particular embodiments, as shown in FIG. 2B, health monitoring systemmay include a health monitoring patch 270 (e.g., positioned on user arm280) and mobile electronic device 230. Similar to health monitoringdevice 210, health monitoring patch 270 may be adhered to a portion ofthe user's body, such as an arm, wrist, leg, ankle, torso, neck, head,any other suitable portion of the body, or any combination thereof.

In particular embodiments, health monitoring device 210 and/or healthmonitoring patch 270 may connect to mobile electronic device 230directly or via network 130, which may facilitate interaction betweenand/or transfer of data between health monitoring device 210 and mobileelectronic device 230 and/or health monitoring patch 270. In particularembodiments, mobile electronic device 230 may be a smartphone-likedevice. Health monitoring device 210, health monitoring patch 270, andmobile electronic device 230 may be connected to network 130, servers140, data stores 150, or any combination thereof. Data (e.g., heartrate, stress level, sleep time, emotional state, etc.) may be stored onhealth monitoring device 210, health monitoring patch 270, mobileelectronic device 230, other client systems 120, data stores 150, othersuitable databases, or any combination thereof. In addition, theprocessing of the data and computations of particular algorithms (asdiscussed below) may be performed by health monitoring device 210,health monitoring patch 270, mobile electronic device 230, on servers140, by any other client system 120, other suitable devices/systems, orany combination thereof. In particular embodiments, the processing ofthe data and computations of particular algorithms may be performed byaccessing user data, frame of reference/baseline data, medical data,other relevant data, or any combination thereof, from data stores 150via network 130. Although this disclosure describes a health monitoringsystem in a particular manner, this disclosure contemplates a healthmonitoring system in any suitable manner and with any suitablecomponents.

FIG. 3 illustrates an example mobile client system 120 (e.g., mobileelectronic device 230). This disclosure contemplates mobile clientsystem 120 taking any suitable physical form. In particular embodiments,mobile client system 120 may be a computing system as described below.As an example and not by way of limitation, mobile client system 120 maybe a single-board computer system (SBC) (such as, for example, acomputer-on-module (COM) or system-on-module (SOM)), a laptop ornotebook computer system, a mobile telephone, a smartphone, a personaldigital assistant (PDA), a tablet computer system, or a combination oftwo or more of these. In particular embodiments, mobile client system120 may have a display screen 310 and a touch sensor 320 as an inputcomponent. In the example of FIG. 3, touch sensor 320 is incorporated ona front surface (e.g., display screen 310) of mobile client system 130.Touch sensor 320 may detect the presence and location of a touch (e.g.,from a finger of a user) or the proximity of an object (e.g., a stylus).In the case of capacitive touch sensors, there may be two types ofelectrodes: transmitting and receiving. These electrodes may beconnected to a controller designed to drive the transmitting electrodeswith electrical pulses and measure the changes in capacitance from thereceiving electrodes caused by a touch or proximity input. In particularembodiments, a user may be presented with a user interface (“UI”) of oneor more applications (e.g., mobile applications) on screen display 310of mobile client system 120, and the user may interact with the UI ofeach of the applications via touch sensor 320.

In the example of FIG. 3, one or more antennae 330, 340 may beincorporated into one or more sides of mobile client system 120.Antennae 330, 340 are components that convert electric current intoradio waves, and vice versa. During transmission of signals, atransmitter applies an oscillating radio frequency (RF) electric currentto terminals of antenna 330, 340, and antenna 330, 340 radiates theenergy of the applied the current as electromagnetic (EM) waves. Duringreception of signals, antennae 330, 340 convert the power of an incomingEM wave into a voltage at the terminals of antennae 330, 340. Thevoltage may be transmitted to a receiver for amplification.

In particular embodiments, mobile client system 120 many include acommunication component coupled to antennae 330, 340 for communicatingwith an Ethernet or other wire-based network or a wireless NIC (WNIC),wireless adapter for communicating with a wireless network, such as forexample a WI-FI network or modem for communicating with a cellularnetwork, such third generation mobile telecommunications (3G), or LongTerm Evolution (LTE) network. This disclosure contemplates any suitablenetwork and any suitable communication component for it. As an exampleand not by way of limitation, mobile client system 120 may communicatewith an ad hoc network, a personal area network (PAN), a local areanetwork (LAN), a wide area network (WAN), a metropolitan area network(MAN), or one or more portions of the Internet or a combination of twoor more of these. One or more portions of one or more of these networksmay be wired or wireless. As another example, mobile client system 300may communicate with a wireless PAN (WPAN) (such as, for example, aBLUETOOTH WPAN), a WI-FI network, a WI-MAX network, a cellular telephonenetwork (such as, for example, a Global System for Mobile Communications(GSM), 3G, or LTE network), or other suitable wireless network or acombination of two or more of these. Mobile client system 120 mayinclude any suitable communication component for any of these networks,where appropriate.

In particular embodiments, the communication component coupled toantennae 330, 340 of mobile client system 120 may be configured todetermine location data based on global positioning system (GPS)signals, cellular triangulation, wireless hotspots, or any suitablemethods for determining location data. In particular embodiments, thelocation service of mobile client system 120 may use one or more methodsof location determination, such as for example, using the location ofone or more cellular towers, crowd-sourced location informationassociated with a WI-FI hotspot, or a GPS function of mobile clientsystem 120. As an example and not by way of limitation, the applicationmay use GPS data as the primary source of location information dependingat least in part on whether mobile client system 120 is able to acquireGPS data within a pre-determined period of time. As another example, ifmobile client system 120 is unable to acquire the GPS data within thepre-determined sampling duration, the application may use the locationdetermined using one or more cellular towers or WI-FI hotspots. Althoughthis disclosure describes a location service using particular methods oflocation determination, this disclosure contemplates a location serviceusing any suitable method or combination of methods of locationdetection.

FIGS. 4A and 4B illustrate example user interfaces according toparticular embodiments of the invention. FIG. 4A illustrates an exampleuser interface 400 showing types of information for a user 410(“Julie”). In a first portion 420, user interface 400 shows informationon the number of steps user 410 has taken during particular hours of aparticular day. In a second portion 430, user interface 400 showsinformation on an activity (e.g., running) that may be used by the userto collect user information. In a third portion 440, user interface 400shows information on current user measurements (e.g., a heart rate).FIG. 4B illustrates an example user interface 450 for a stressdetermination that includes a first user interface 450 a and a seconduser interface 450 b. First user interface 450 a includes a category(e.g., “stress” 460) describing the information illustrated, and agraphical representation 470 of a stress level associated with the user.First user interface 450 a also includes a chart option 472, whichchanges the user interface 450 to second user interface 450 a. Seconduser interface 450 a shows a log 480 of past stress level information490 save for the user. In particular embodiments, other stress-relatedinformation may be provided to the user (or an option may be provided tothe user for collecting particular types of stress-related information)via user interface 450. Although this disclosure describes example userinterface for a health monitoring system in a particular manner, thisdisclosure contemplates providing user interfaces for a healthmonitoring system in any suitable manner to provide information to theuser.

Stress Detection

As discussed above, stress is considered to be one of the largestcontributors to various health problems. Stress management techniquestend to be inaccurate and instable, especially in the presence of noise.Accordingly, particular embodiments discussed below address these issuesby providing an HRV algorithm applicable to detecting stress as well asmeasuring relaxation that is based on an analysis of SVB. SVB is oneconcept behind psychophysiological description of stress, and theanalysis of SVB is based on a ratio approach that provides HRV (e.g.,stress) values in terms of a percentage deviation from normal. Thisapproach is linear in nature, which makes it very stable to noise (e.g.,which tends to be nonlinear in nature). In addition, this approach ishighly customizable to address the unique needs of the user, otherusers, or medical professionals.

Stress management techniques that work by measuring theactivities/arousal of ANS, where high arousal is considered a sign ofstress, tend to focus on the parasympathetic nervous system (PSNS)rather than the sympathetic nervous system (SNS). However, this may beproblematic because an increase in the PSNS may not necessarily imply adecrease in the SNS, and thus, analysis of the SNS may be as useful asthe analysis of the PSNS. In contrast, as discussed in more detailbelow, the methods based on analyzing SVB looks at the homeostaticequilibrium where the sympathetic outflow and PSNS (e.g., vagal nerve)outflow are in stable balance. Accordingly, SVB, and hence stress, maybe determined by analyzing relative dominance and balance between theSNS and PSNS (e.g., between parasympathetic outflow and sympatheticoutflow).

A problem also arises in that both the SNS and PSNS are not easilyquantified and compared because they have no accepted unit ofquantification, which leads to numbers that are hard to interpret andevaluate. The analysis of SVB described treats the SNS and PSNS withequal weightage (e.g., because they are both useful in analyzing the ANSarousal) and uses the most elementary unit of HRV, which is not heartrate (HR) but RR-deltas (e.g., RR interval differences betweensuccessive heart beats). In addition, the profusion of inexpensive,user-friendly, wearable sensors makes it easier to collect data andanalyze SVB using a large volume of data in real-life settings and inreal-time. In particular embodiments, to determine SVB, stress isdefined as increased dominance of the SNS in the RR-delta histogramH_(t) of test data t, and the data points on the histogram correspond tothe difference between a length of adjacent RR intervals in a set oftest data. In particular embodiments, the methods described belowcomputes only a ratio of a number of events relatively mapped to SNSwith a number of events relatively mapped to PSNS. Divisions between SNSand PSNS, their individual range for the given user, can be labeledusing methods such as RMSSD, SDNN, pNN50, etc. In addition, irrespectiveof which measurement method is chosen, the data points that are computedare dimensionless. As an example and not by way of limitation, given abaseline SVB of the user, and an RR-delta histogram H_(t), the SVB maybe computed as a median of all RR-deltas, a mean value of all RR-deltas,50% of RMSSD, computed over H_(t), 50% of SDNn, computed over H_(t),other relevant values, or any combination thereof.

In particular embodiments, given a baseline data histogram H_(b), testdata histogram H_(t), and an algorithm ALG_(X) to determine a marker ofthe ANS activity in test data histogram H_(t) (e.g., an algorithm thatcan compute HRV over the histogram, or count number of instances ofRR-deltas in different segments of the histogram computation algorithm),the method comprises (1) computing SVB from baseline data histogramH_(b), (2) determining segment H_(Lt) and segment H_(Rt) the segments intest data histogram H_(t) respectively to the left and right of SVBpoint, (3) using algorithm ALG_(X), computing the desired measure ofRR-variability (a direct effect of ANS arousal) in both the left segmentH_(Lt) and the right segment H_(Rt), and (4) computing the HRV as aratio of the algorithm ALG_(X) measure of RR-variability in the leftsegment (ALG_(X) (H_(LT))) with the measure of RR-variability in theright segment (ALG_(X) (H_(RT))), or from the total histogram ALG_(X)(H_(T)). Then, for easy standardization or comparison between differentusers, the HRV zones may be pre-defined as: 0-20 being representative of“very stressed,” 20-40 being representative of “stressed,” 40-60 beingrepresentative of “normal,” 60-80 being representative of “relaxed,” and80-100 being representative of “very relaxed.”

FIG. 5A illustrates an example of baseline data histogram 500. As shownin FIG. 5A, an x-axis of baseline data histogram 500 corresponds toheart rate fluctuations (e.g., RR-deltas), and a y-axis of baseline datahistogram 500 corresponds to a number of times of the heart ratefluctuations for a set of baseline data. The SVB point is the point of50:50 distribution of baseline data histogram 500 such that 50% of thedata points of the set of baseline data are to the left of the SVB and50% of the data points of the set of baseline data are to the right ofthe SVB. Using baseline data histogram 500, the SVB may be computed andmay correspond to an HRV zone representative of a “normal” (e.g.,non-stressed) state.

FIG. 5B illustrates an example of a test data histogram 510 in which theSVB is shifted to the left, and FIG. 5C illustrates an example of a testdata histogram 520 in which the SVB is shifted to the right. As shown inFIG. 5B, similar to FIG. 5A, an x-axis of test data histogram 510corresponds to heart rate fluctuations (e.g., RR-deltas), and a y-axisof test data histogram 510 corresponds to a number of times of the heartrate fluctuations for a set of test data. When the heart ratefluctuations for the set of test data on average results in the shiftingof balance from histogram A1 (e.g., corresponding to the baseline data)toward a left direction to histogram A2, or in other words, the numberof measurements of heart rate fluctuations of histogram A2 that are tothe left of the SVB (e.g., as determined based on the baseline data) aregreater than the number of measurements of heart rate fluctuations ofhistogram A2 that are to the right of the SVB, then it is determinedthat the user's state corresponds to a HRV zone representative of a“stressed” state. Explained another way, as shown in FIG. 5B, given atotal area A, the area of A2 over A (e.g., the area under the curve ofA2) is determined to be less than the area of A1 over A (e.g., the areaunder the curve of A1) when the histogram shifts to the left and it isdetermined that the user's state corresponds to a HRV zonerepresentative of a “stressed” state.

On the other hand, as shown in FIG. 5C, similar to FIG. 5A, an x-axis oftest data histogram 520 corresponds to heart rate fluctuations (e.g.,RR-deltas), and a y-axis of test data histogram 520 corresponds to anumber of times of the heart rate fluctuations for a set of test data.When the heart rate fluctuations for the set of test data on averageresults in the shifting of balance from histogram A1 (e.g.,corresponding to the baseline data) toward a right direction tohistogram A2, or in other words, the number of measurements of heartrate fluctuations of histogram A2 that are to the right of the SVB(e.g., as determined based on the baseline data) are greater than thenumber of measurements of heart rate fluctuations of histogram A2 thatare to the left of the SVB, then it is determined that the user's statecorresponds to a HRV zone representative of a “relaxed” state. Explainedanother way, as shown in FIG. 5C, given a total area A, the area of A2over A (e.g., the area under the curve of A2) is determined to begreater than the area of A1 over A (e.g., the area under the curve ofA1) when the histogram shifts to the right and it is determined that theuser's state corresponds to a HRV zone representative of a “relaxed”state.

Particular embodiments of this embodiment depend on creatively dividingthe RR-delta histogram, H_(T), based on the notion of contextuallyappropriate SVB. As an example and not by way of limitation, if thecontext is all the cyclic components responsible for variability in theperiod of recording, then the ratio for SVB may be evaluated via theSDNN(H) model.

In particular embodiments, a length of a buffer of the RR-delta datathat is used to populate the histogram need not be limited to some fixedsize during the computation of stress. Since the algorithm provides ameasure of SVB, even if a longer length of data is used, above a certainminimum length, the SVB would nonetheless be meaningfully depicted eventhough the nature of the stress plot may be somewhat different. As such,the buffer length may be varied based on the requirements of accuracy,stability, or any other attribute where a variable length may bebeneficial.

In particular embodiments, using multiple other types of sensors orbiomarkers not solely focused on HR analysis may enrich the algorithmseven further. As an example and not by way of limitation, data regardingthe nature of the blood flow from PPG, or ECG features, galvanic skinresponse (GSR) measurements, EEG characteristics, blood pressure such asin pulse wave transit time (PWTT) may be used to give additionalinformation about ANS. This information may be used to further inform oradjust the proposed HRV algorithm. As an example and not by way oflimitation, the above-mentioned variable length buffer may be adjustedusing such information. In addition, the final stress computed may beconsidered as a composite of ANS quantification provided by the proposedHRV algorithm and other markers from sensors such as PPG, ECG, EEG, GSR,etc. Such data fusion may be initiated per the user's choice, forexample, during the times when the stress computed exceeds a certainthreshold so that before sounding an alarm, the HRV computations may befurther reviewed or adjusted. Utilizing multiple types of measurementsmay be considered all at once, or may be considered as needed (e.g., oneby one). As an example and not by way of limitation, HRV data and bloodflow data may be collected, and then based on these sets of data, astress level may be estimated. As another example and not by way oflimitation, HRV data may collected and the stress level may bedetermined. If the stress level is above or below a threshold, bloodflow data may be used to confirm or adjust the stress level estimate. Asyet another example and not by way of limitation, different sensormeasurements may be dynamically chosen to be used for stress estimationbased on the noise level of the sensor measurement (e.g., if blood flowdata is determined to be unreliable, health monitoring device 210 mayselect to omit using blood flow data).

In addition, the above-discussed algorithms have the benefit of highflexibility. In particular embodiments, the algorithms may be used toprovide a variety of services that may include providing the physician awarning during a panic stress episode (e.g., in which case thealgorithms may compute a variety of histograms of different length sothat the stress computed may be validated in as many ways as possible);warning a driver during a high speed drive under high stress (e.g., whenthe histogram computed is of the minimal possible length so that awarning can be given as early as possible); alerting a student during anepisode of severe stress while at school (e.g., where the stresscomputed has features expected to be present during an exam such as astress continuously rising throughout the exam or at school, or tolocate unusually severe episodes such as when the HRV is very high whilethe HR has dipped very low compared to the baseline), etc. Thus, giventhe flexibility inherent in the stress computing/warning algorithms anda wide variety of applications in which such information may useful, onecan easily adjust the various steps required in computing ofpsychophysiological stress or even the SVB per the proposed algorithmmay be easily adjusted (e.g., automatically by health monitoring device210, by the user, by a third party, etc.).

Moreover, the above-discussed algorithms may facilitate a number ofservices. As an example and not by way of limitation, example servicesmay include integration with a car, patches worn by the user (e.g., asshown in FIG. 2B), interfacing with a virtual reality device or gameconsole, etc. In the last situation, the virtual reality device or gameconsole may adjust its content based on the user's stress level (e.g.,adjust the dram level of the soundtrack or adjust the game'sdifficulty).

FIG. 6 illustrates an example method 600 for stress detection. Theexample method 600 may be deployed on one or more electronic devices,such as a mobile phone, tablet computer, smart watch, head-mounteddevice, body-harness-secured devices, and the like mobile devices,wearable devices, fixed-location computing devices, and/or network orcloud deployed systems, having suitable communication, processing,sensing facilities, other suitable devices, or any combination thereof.In particular embodiments, measurement data may include variations inthe beat to beat heart rate (RR-delta), skin conductance, frequencycomponents inherent in electrical activity on scalp, inhalation andexhalation patterns, etc. As an example and not by way of limitation,the measurement data can be measured using heart rate measurementsensors such as electrocardiogram (ECG), electrodermal analysis sensors,EEG headset, respiration sensors, other suitable sensors, or anycombination thereof. As another example and not by way of limitation, aprocessor or circuitry may embody the method (e.g., one or more computerprocessors may be communicatively coupled to a data storage device thatstores instructions executable by the one or more computer processors toperform operations of example method 600 for stress detection).

In particular embodiments, the method 600 may be performed by healthmonitoring system 200. The method 600 may be for the purpose ofdetermining a stress level of a user based on a SVB value calculatedfrom a set of measurement data. The method 600 begins at step 610, wherehealth monitoring system 200 may determine a baseline SVB based at leaston baseline data. At step 620, health monitoring system 200 maydetermine a first portion of a set of measurement data that is on oneside of the baseline SVB. At step 630, health monitoring system 200 mayprocess the first portion of the set of measurement data to determine anumber of ANS activity markers within the first portion. Then, at step640, health monitoring system 200 may determine a HRV characteristic asa ratio involving the number of ANS activity markers within the firstportion and the number of ANS activity markers within a second portionof the measurement data. The first and second portions of the set ofmeasurement data are selected based on a baseline SVB value (e.g., auser-specific baseline SVB value) that divides a histogramrepresentation of the set of measurement data into the first and secondportions. Then, the method 600 may terminate. Alternatively, the method600 may determine the stress level of the user based on the HRVcharacteristic prior to terminating.

In particular embodiments, prior to determining the HRV characteristic,the method 600 may determine a baseline SVB value based at least onuser-specific baseline data, determine the first portion of the set ofmeasurement data that is on a first side of the SVB, and then processthe first portion of the set of measurement data to determine the numberof ANS activity markers within the first portion. The second portion ofthe set of measurement data may include the set of measurement data lessthe first portion of the set of measurement data. In particularembodiments, the method 600 may process the second portion of the set ofmeasurement data to determine the number of ANS activity markers withinthe second portion.

In particular embodiments, the method 600 may receive, from a sensor ofan electronic device of the user, the set of measurement data, andgenerate, based on the set of measurement data, a histogram of the ANSactivity markers. The histogram of the ANS activity markers may bedivided into the first and second portions such that the number of ANSactivity markers in the first portion substantially equal the number ofANS activity markers in the second portion. The user-specific baselineSVB value may correspond to a position on the histogram where the numberof ANS activity markers in the first portion substantially equal thenumber of ANS activity markers in the second portion. In addition, theelectronic device may include at least a wearable electronic device, andthe histogram of the ANS activity markers may be determined by thewearable electronic device. The user-specific baseline SVB value may bedetermined by the electronic device. In addition, the stress level ofthe user may be determined by comparing the number of number of ANSactivity markers in the first portion with the number of ANS activitymarkers in the second portion.

In particular embodiments, the ANS activity markers may include one ormore SNS activity markers and one or more PSNS activity markers. The ANSactivity markers within the first portion of the set of measurement datamay include the one or more SNS activity markers, and the ANS activitymarkers within the second portion of the set of measurement data mayinclude the one or more PSNS activity markers. The HRV characteristicmay be determined based on a ratio involving a number of the SNSactivity markers to a number of the PSNS activity markers. In addition,the HRV characteristic may be determined based on the ratio of thenumber of the SNS activity markers to the number of the PSNS activitymarkers being approximately 50:50.

In particular embodiments, the ANS activity markers may contribute tothe first and second portions based on a first probabilistic weightcorresponding to the first portion and a second probabilistic weightcorresponding to the second portion. Each of the ANS activity markersmay contribute to sympathetic nervous system (SNS) activity based on thefirst probabilistic weight and to parasympathetic nervous system (PSNS)activity based on the second probabilistic weight. In addition, theuser-specific baseline SVB value may correspond to a range of SVBvalues, and the stress level of the user may correspond to a range ofstress-level values.

Particular embodiments may repeat one or more steps of the method ofFIG. 6, where appropriate. Although this disclosure describes andillustrates particular steps of the method of FIG. 6 as occurring in aparticular order, this disclosure contemplates any suitable steps of themethod of FIG. 6 occurring in any suitable order. Moreover, althoughthis disclosure describes and illustrates an example method for stressdetection including the particular steps of the method of FIG. 6, thisdisclosure contemplates any suitable method for stress detectionincluding any suitable steps, which may include all, some, or none ofthe steps of the method of FIG. 6, where appropriate. Furthermore,although this disclosure describes and illustrates particularcomponents, devices, or systems carrying out particular steps of themethod of FIG. 6, this disclosure contemplates any suitable combinationof any suitable components, devices, or systems carrying out anysuitable steps of the method of FIG. 6.

In particular embodiments, a probabilistic approach may be desirablebased on the limitations of sensors. As an example and not by way oflimitation, a 1 KHz sampling rate may be required for ANSquantification, but this may give rise to a number of problems becausemany sensors only have a 100 Hz sampling rate, and thus 10 millisecond“bins.” In particular embodiments, data points close to the median maybe assigned fractional presence in the other side of the histogram. Asan example and not by way of limitation, assume that a data point “x”has been assigned a position in bin number “i,” where the first bin islabeled to be bin number 1. Based on the bin size, a position adjacentto the baseline in the histogram may have a significant likelihood ofbeing present in the other side of the histogram. FIG. 7A illustrates aprobabilistic approach for low noise in the data measurements, and FIG.7B illustrates a probabilistic approach for high noise in the datameasurements. As shown in FIG. 7A and FIG. 7B, an x-axis of histogram700 (or histogram 710) corresponds to heart rate fluctuations (e.g.,RR-deltas), and a y-axis of histogram 700 (or histogram 710) correspondsto a number of times of the heart rate fluctuations for a set of data.As an example, as shown in FIG. 7A, the baseline SVB is equal to 30, andfor a data point x at 31, example assignments for the left side andright side of histogram 700 may include Prob(x_left)=0, andProb(x_right)=1.

In particular embodiments, this assignment is a function of the bin sizeas well as noise inherent in the signal. Thus, given a particular binsize α, for Noise_x(β_(t,j)) at the j^(th) position in a time seriesβ_(t), and RR-interval computation approach φ_(k), it may be determinedthat:

Prob(x_left)#0, where Prob(x_left)=f(Noise_x(β_(t,j)),α,φ_(k))

In general, the probability of a point x may be quantified not just inthe left or right portions around the baseline, but also at each bin inthe histogram. This may allow for the baseline SVB to be updated, whichis not possible if the quantification is only dependent on theprobabilistic position of the point on either side of the baseline. Asan example and not by way of limitation, suppose there are five pointson each side of the baseline SRV of 30, where the bin size is 1millisecond. As shown in FIG. 7B, in the situation where the next pointx has an RR-delta of 31 and the noise in the time series is fairly high,then the method will assign a fractional weight (presence) of 0.5 oneither side of the baseline. This is due to the high uncertaintyintroduced in the actual RR-delta computations. Accordingly, exampleassignments for the left side and right side of histogram 710 mayinclude: Prob(x_left)=0.5−ε, and Prob(x_right)=0.5+ε, where ε is afunction of noise and distance of x from the baseline SVB, which may beapproximated by one-sided Gaussian or the polynomial that best fits thehistogram envelope. In addition, the quantification of noise for robustmeasurements of Noise_x(βt,j) are discussed in more detail below.

FIG. 7C illustrates a probabilistic approach for updating a baseline SVBbased on a probabilistic determination. As shown in FIG. 7C, an x-axisof histogram 720 corresponds to heart rate fluctuations (e.g.,RR-deltas), and a y-axis of histogram 720 corresponds to a number oftimes of the heart rate fluctuations for a set of data. In particularembodiments, the probability Prob(x[i±h]) of point x being in anotherbin, at a distance of h from the original bin i, increases in presenceof greater noise. As an example and not by way of limitation, as shownin FIG. 7C, the probability associated with bin i−1 is Prob(x[i−1]), andthe probability associated with bin i−2 is Prob(x[i−2]). In addition,this probability may be different in two different users even in thepresence of the same extent of noise due to the inherent stochasticityin their HRV signal. In particular embodiments, health monitoring system200 may collect signal data under normal conditions, as indicated by theuser, as well as for a short period, such as few minutes, under someexpected or reasonable noisy conditions. This may be helpful inproviding a measure of the probability of the signal data underdifferent bins. Once the noise is quantified, health monitoring system200 may obtain a measure of the probability Prob(x[i±h]) of point xbeing in another bin at a distance of h from the original bin number i.In particular embodiments, a variety of simulations may be carried outto determine the behavior of signal data under noisy conditions wherethe noise need not be introduced by actual physical movements, but maybe introduced synthetically in the baseline SVB signal to provide adatabase for computing the probabilistic models and hence a moreaccurate SVB measure. FIG. 7D illustrates a graph 730 that shows a rangeof stress values over time for a user. As shown in FIG. 7D, stressvalues associated with the baseline SVB may be corrupted by noisysignals, and thus health monitoring system 200 may obtain a measurementof SVB that corresponds to a range of stress values. The graph can bedisplayed within the user interface 450 of FIG. 4B in accordance with anexample embodiment.

Finally, note that in an example method the ΔRR values are computed withreference to multiple key PPG features. For example, a separate ΔRR canbe computed each from trough, peak, and zero-crossing features. Or, aseparate ΔRR can also be computed from other signal processingtechniques such as mutual information (as detailed later). The final ΔRRvalue can then be selected based on the quality of the given signalfeature as well as physiological factors. The quality of the signalfeature can be judged by examining the noise around that feature. Forexample, if the signal around supposed peak of the PPG is found to bevery noisy as compared to the signal around the trough, then ΔRRselected from PPG peak is given lower priority as compared to the ΔRRcomputed from PPG trough. In an example aspect, among others, thephysiological reasoning behind selecting or weighting the ΔRR isprimarily driven by the consideration that the body tries to maintainthe stress homeostasis. Thus, given a large discrepancy in ΔRR frommultiple features, the ΔRR that minimizes the change in stress may berelatively accurate. This may have a large effect when different ΔRRfall on different sides of the baseline. In presence of a tie, inaccordance with an example embodiment, the method selects the zerocrossing based RR, whose accuracy may be justified by the rapidly risingsignal at the zero crossing point. Hence, even a moderately large errorin estimating the zero in the signal may not translate to a large errorin the time stamp. This nature of zero crossings is a result of theblood flow pattern in which the blood volume rises very rapidly duringthe systolic phase (the zero crossing lies in the systolic phase).

Weighted Left-Shift and Histogram Profile Refinement

In particular embodiments, most HRV-based algorithms to detect stressmay simply be measuring the extent to which the histogram of successivebeat-to-beat RR-deltas has shifted to the left (e.g., to a more stressedstate). In particular embodiments, smart left-shift algorithms aresimilar to the SVB computation approach, but with the understanding thatdifferent parts of the histogram may have varying importance. Inaddition, since stress may correspond to a left shift of the histogramfrom its baseline state, this may be computed as a reduction of thescaled area of the histogram by adjusting the area of the histogrambased on the “expected weight” of different histogram regions. Since thehistogram may be considered to be broken into “n” number of bins eachcreated due to the sensors having limited sampling rates, a left shiftalgorithm may be created by computing a scaled area of the histogramthat is reduced compared to its baseline area in presence of stress.FIG. 8 illustrates an example of a histogram 800 exhibiting left shiftfrom a baseline state. As shown in FIG. 8, histogram 800 is shown tohave shifted to a position 810 heavily favoring the left portion of thehistogram from a baseline position 820.

In particular embodiments, while a traditional area of a histogram forSVB computation=Σy_(i)*(width of band i), a scaled area determined basedon the left shift algorithm=SA=Σx_(i)y_(i)k_(i), where x_(i)=x axisvalue of band i, y_(i)=total samples in band i, and k_(i)=A scalingfactor for bin ‘i’ based on its value assessment. In particularembodiments, an expected weight of the scaled area may be, for example,calculated based on a function set by the therapist or by the userhimself based on the noise profile of the signal. The pre-set bias maybe corrected by giving lower probability of RR-delta instances incertain areas, if required. In addition, weights may be determined basedon probability distribution which assigns instances to belong to morethan one bin based on the uncertainty introduced by the extent of noise.

In particular embodiments, in computing the scaling factors, to givelarger weight to the left part of the histogram, the left-most regionmay be assigned a lower weight if RR-delta=0 is the default assignmentin the presence of noisy heartbeat-to-heartbeat variability. Higherweight to the right most region may be assigned if instances of datapoints are large and rare. In addition, the scaling factor may bemodulated based on the accelerometer (e.g., via activity detection). Inparticular embodiments, the outliers in the histogram may create strongvariability in the result, and thus the SVB computation may be furtherrefined by calculating the left shift by characterizing the profile ofthe histogram's envelope. As shown in FIG. 8, the “envelope” may beconceptually considered to be characterized by a small number of “goalposts” (e.g., interquartile range or mode-based goal-posts). The leftshift algorithm may be further refined by the rejection of certainclasses of outliers. In particular embodiments, for calculating stress,these techniques try to create an appropriate desensitization of thehistogram “tail” (e.g., the right-most portion of the histogram). Inaddition, the left shift algorithm may be further refined by using theexpected performance or past historical trends, leading to an approachwhere the weights are assigned based on a probability distribution.

Noise Detection/Correction and Error Compensation

As discussed above, stress can contribute to various health problems,and thus accurate, robust, and meaningful measurement of psychologicalstress can be advantageous in the monitoring and management of healthand/or wellness. Real-life bio-sensing measurements may be noisy andbiosignals derived from these measurements may be noise sensitive. Forexample, the source of noise may be motion artifacts, erratic and/orlose body-sensor contacts, a wide variety of ambient disturbances, otherrelevant noise, or any combination thereof. Such noise is highlyprominent in photoplethysmogram (PPG) signals, which is a sensitivebio-signal with low tolerance for anything less than ideal collectionand analysis methods. Particular embodiments discussed below pertain tomethods for performing accurate biosensing of PPG signals with noisymeasurements. In addition, the particular embodiments discussed belowmay also pertain to monitoring and analyzing other suitable bio-signalsrelevant to health and/or wellness with noisy measurements. Inparticular embodiments, these methods may help to deal with issues suchas imprecise and difficult to interpret measurement algorithms, waste ofpower while computing and/or collecting unnecessary data that need notto be collected (e.g., due to the knowledge of a high likelihood ofnoise in the data), the lack of usability, actionability,contextualization, and personalization of the collected data (e.g., dueto noise artifacts), and erratic performance in the presence of noise.

FIG. 9 illustrates an example method 900 for computing healthmeasurements using noisy sensors. The method 900 may be performed by abiosensing device (e.g., one or more devices of health monitoring system200), such as, a wearable device (e.g., a smart watch similar to healthmonitoring device 210, a patch such as health monitoring patch 270,etc.), a mobile device (e.g., a smart phone such as mobile electronicdevice 230, etc.), a specialized monitoring device (e.g., a medicaldevice, etc.), other suitable devices, and any combination thereof (asdescribed above with regard to FIGS. 1 and 2A-2B). As an example and notby way of limitation, health measurements may include stress, heartrate, sleep, emotional state, other relevant measurements, or anycombination thereof.

The method may begin at step 902, where health monitoring system 200 mayreceive a sensor signal. As an example and not by way of limitation, thesensor signal may correspond to a PPG signal, an ECG signal, abio-impedance signal, arterial blood pressure (BP signal), othersuitable signals, or any combination thereof. For example, the PPGsignal may be used to calculate HRV, which in turn, may be used tocalculate a stress level of a user. However, noise in the PPG signal maycause an increase in variability in the HRV calculation, which mayresult in an erroneously low stress measurement. Thus, a primary goal ofparticular embodiments described below is to correct this errorresulting from the noise in the PPG signal and provide the user withfeedback about the quality and efficacy of the health measurements.

At step 904, health monitoring system 200 may quantify the noise of thereceived signal. In particular embodiments, the noise may be measured orquantified in terms of variation in the expected amplitude of thesignal. As an example and not by way of limitation, an unexpected changein the signal amplitude from the average baseline amplitude may be avery reliable indication of the existence of noise in the signal.Example noise quantification will be described in greater detail belowin connection with FIGS. 11, 12A, and 12B.

In accordance with example embodiments, noise can be computed in avariety of different ways. One approach of an example embodiment is tocompute the noise as the ratio of the total area of the signal with theaverage signal in the clean PPG signal. If this ratio is significantlyoutside the expected range then the signal can be deemed noisy, and thisratio can serve to quantify the level of the noise. Another approach ofan example embodiment is to estimate the number of peaks (or troughs) inthe given pulse and if the given number is above a threshold then thisis a quantifier of the noise in the signal. Yet another approach of anexample embodiment is to measure the RMS deviation of the signal fromthe expected profile and this measure can be taken as the noise level ofthe signal. Yet another of an example embodiment is that for each peakand trough and zero crossing that is calculated, the expected signalprofile in the vicinity of such features is calculated by curve fitting.Then the RMS deviation of the actual signal from the expected signal isused as the quantification of the overall noise in the signal for thegiven feature. As a further refinement of this approach, if a particularfeature of the signal is used for the RR calculation then the noise inthe vicinity of that feature is used as the marker of the noise in thesignal.

One particular error-noise model may be more suited for error correctionin a given setting, and that particular noise model can be taken as thepreferred model. In an example embodiment, the health monitoring system200 determines which error-noise model is to be selected automatically.For instance, the health monitoring system 200 can introduce syntheticnoise in a clean PPG and measure the accuracy of correction of eacherror-noise model. The error-noise model with the highest accuracy(e.g., lowest error) can be selected.

Further, in a number of situations, the signal may be so corrupted thatit is not possible to estimate any feature at all. In such a case, thenumber of such pulses (obtained by the extrapolation from the averageheart rate) in the overall signal is used as a marker of overall noisein the signal. However, each noisy RR may corrupt, e.g., three RR-deltameasurements. Hence, the noise that is discretely distributed in thesignal may have a larger effect than noise that is present in acontinuous stretch. For example, if the noise only affects one pulse,and such single noisy pulse instances are distributed throughout thesignal then it can lead to, e.g., 30 noisy RR-delta computations andhence this case corrupts the signal more than the case where, e.g., 10noisy pulses are consecutive. This information about the total expectednumber of RR-delta that are either erroneous or are simply notcalculable can be a meaningful quantification of the total noise in thesignal.

Health monitoring system 200 may continue method 900 by performing steps906 and 910 sequentially or in parallel. At steps 906 and 908, healthmonitoring system 200 may provide the noise quantification to the userfor feedback and further may provide the noise quantification forstatistical correction. Example statistical correction will be describedin greater detail below in connection with FIGS. 14A-C.

At step 910, health monitoring system 200 may determine whether peakdetection of the received signal is possible. As an example and not byway of limitation, health monitoring system 200 may attempt to determinepeaks of the sensor signal having certain properties such as awell-formed morphology that has repeated and detectable features in eachcycle (e.g., a sinusoidal-type signal in the proximity of the peak inthe well-formed PPG signal). If it is determined at step 910 that peakdetection is possible (e.g., a determination of “YES”), healthmonitoring system 200 may proceed to step 912, where health monitoringsystem 200 may perform peak detection. Then, based on the detected peakinformation, at step 914, health monitoring system 200 may determinesignal features for a health algorithm (e.g., a stress algorithm). As anexample and not by way of limitation, the signal features may include apeak-to-peak time for HRV calculation, as described in more detail belowin connection with FIGS. 15 and 16.

On the other hand, if it is determined at step 910 that peak detectionis not possible (e.g., a determination of “NO”), health monitoringsystem 200 may proceed to step 916, where health monitoring system 200may determine whether statistical prediction is possible. In particularembodiments, health monitoring system 200 determines whether statisticalprediction is possible by looking at the statistical properties of priorPPG signals, and then based on this information, determine whether it ispossible to reconstruct one or more missing pieces of a signal withreasonable accuracy. However, if the prior PPG signals are determined tobe pure noise, then health monitoring system 200 may determine that noinformation may be extracted to help build the missing signal, and thusthe reconstruction or prediction of the signal is also not possible. Inother words, if it is determined at step 916 that signal prediction ispossible (e.g., a determination of “YES”), then health monitoring system200 may move to step 918 to perform signal prediction and adjust thereceived signal based on the predicted signal, and then to step 920 toreduce the effect of the noise.

On the other hand, if it is determined at step 916 that signalprediction is not possible (e.g., a determination of “NO”), then healthmonitoring system 200 may move to step 922 to perform noise compensationby using noise-error plots, as described in more detail below inconnection with FIGS. 14A-C. Then, at step 924, health monitoring system200 may correct the health (e.g., stress) computation based on the noisecompensations from step 922. After correcting the health computation,the method may terminate.

Particular embodiments may repeat one or more steps of the method ofFIG. 9, where appropriate. Although this disclosure describes andillustrates particular steps of the method of FIG. 9 as occurring in aparticular order, this disclosure contemplates any suitable steps of themethod of FIG. 9 occurring in any suitable order. Moreover, althoughthis disclosure describes and illustrates an example method forcomputing health measurements using noisy sensors including theparticular steps of the method of FIG. 9, this disclosure contemplatesany suitable method for computing health measurements using noisysensors including any suitable steps, which may include all, some, ornone of the steps of the method of FIG. 9, where appropriate.Furthermore, although this disclosure describes and illustratesparticular components, devices, or systems carrying out particular stepsof the method of FIG. 9, this disclosure contemplates any suitablecombination of any suitable components, devices, or systems carrying outany suitable steps of the method of FIG. 9.

FIG. 10 illustrates a noise compensation system 1000 (e.g., of healthmonitoring system 200) for computing health measurements using noisysensors. Noise compensation system 1000 may include one or more sensors(or a sensor interface) 1002 to receive sensor data from the user and/orfrom health monitoring system 200. Sensors 202 may provide the sensordata (e.g., HR data, user activity data, etc.) as an input to areal-time noise quantification module 1004 and a real-time healthmonitor module 1006. Real-time noise quantification module 204 maygenerate a computed noise level in the sensor data (e.g., step 904 ofFIG. 9 of quantifying the noise of the received signal), and real-timehealth monitor module 1006 may generate a computed health measurementbased on the noisy sensor data. Then, the computed noise level of thesensor data (from real-time noise quantification module 1004) and thecomputed health measurement (from real-time health monitor module 1006)may be provided as inputs to a health-error module 1008 to generate areal-time noise analysis. The outputs of the health-error module 1008may then be provided to the user via a user interface (UI) 1010 in orderto provide feedback to the user on the noise level of the sensor data(e.g., via user interfaces shown in FIGS. 4A and 4B). The real-timenoise analysis of health-error module 208 will be described in moredetail below in connection with FIGS. 14A-C.

Additionally or alternatively, the computed health measurements (fromreal-time health monitor module 1006) may be provided to a post-hocnoise analysis module 1012, which may be communicatively coupled to ahealth database 1014. Health database 1014 may maintain a data record ofpast computed health values and various baseline values (e.g.,user-specific baseline values). Post-hoc noise analysis module 1012 maystore the received computed health measurement in health database 1014.Periodically (e.g., every 24 hours), post-hoc noise analysis module 1012may process the stored health measurements and/or baseline values andmay provide post-hoc analysis data to the user for feedback (e.g., viaUI 1010, as discussed above). In addition, post-hoc noise analysismodule 1012 may use the post-hoc analysis data to update the noise modelof noise compensation system 1000. The post-hoc noise analysis module212 will be described in more detail below in connection with FIG. 13.

Particular embodiments may include one or more additional modules and/orrepeat one or more steps described in relation to noise compensationsystem 1000 of FIG. 10, where appropriate. Although this disclosuredescribes and illustrates particular modules and particular stepsdescribed in relation to FIG. 10 as part of a particular setup and/oroccurring in a particular order, this disclosure contemplates anysuitable setup with regard to noise compensation system 1000 of FIG. 10.Moreover, although this disclosure describes and illustrates an examplenoise compensation system 1000 including particular modules used inparticular ways, this disclosure contemplates any suitable noisecompensation system 1000 including any modules, which may include all,some, or none of the modules of FIG. 10, where appropriate. Furthermore,although this disclosure describes and illustrates particularcomponents, devices, or systems carrying out particular steps describedin relation to noise compensation system 1000 of FIG. 10, thisdisclosure contemplates any suitable combination of any suitablecomponents, devices, or systems carrying out any suitable stepsdescribed in relation to noise compensation system 1000 of FIG. 10.

Signal Correction

As discussed above, there are many sources of noise—such as, motionartifacts, noisy contacts, sensor errors, and the like—and accurate peakdetection or signal correction may be difficult. In such cases, noisecompensation by removing noise and/or compensating for noise mayfacilitate determining accurate measurements of stress and/or HRV.Specifically, noise can increase the variability of collected signaldata, which may erroneously increase the perceived variability in theHRV computation, which may then erroneously affect the stress output.

FIG. 11, for example, illustrates an example method 1100 for determininga health-variability measurement (e.g., HRV or stress level) of a user.The method may begin at step 1110, where health monitoring system 200may receive, from a sensor of an electronic device of the user (e.g.,mobile electronic device 230), sensor data. In particular embodiments,the sensor data may include data on a PPG signal over anoise-calculation period, and the health-variability measurement mayinclude a HRV measurement. At step 1120, health monitoring system 200may determine a noise level of the received sensor data. Thedetermination of the noise level can be based on one or more of theapproaches described above in connection with block 904 of FIG. 9.

Then, at step 1130, health monitoring system 200 may adjust thehealth-variability measurement by an amount calculated based on thedetermined noise level. In particular embodiments, the adjusting of thehealth-variability measurement by the amount calculated based on thedetermined noise level may include decreasing the health-variabilitymeasurement by the calculated error-adjustment measurement. For example,FIGS. 12A and 12B illustrate examples of HRV measurement noisecompensation results. Specifically, FIG. 12A illustrates noisecompensation results 1200 including a noisy stress signal and anadjusted stress signal after compensation over a 60 second window oftime, and FIG. 12B illustrates noise compensation results 1210 includinga noisy stress signal and an adjusted stress signal after compensationover a 120 second window of time. As shown in both FIGS. 12A and 12B inconnection with the error-noise curves, as the percentage of noiseincreases in a signal, the percentage of resultant error also increases.Thus, a noisy signal may result in an artificially elevated (and thusinaccurate) HRV computation and thus an artificially decreased stresscomputation in comparison with the signal after noise compensation. Withnoise compensation, the stress level is adjusted upward by the errordetermined based on the noise level and the error-noise curve in orderto obtain a more accurate stress level of the user. In particularembodiments, after adjusting the stress measurement, health monitoringsystem 200 may send the adjusted stress measurement to the electronicdevice of the user (e.g., mobile electronic device 230).

The method of FIG. 11 was described in the context of adjusting thestress computation directly to compensate for noise. However, the HRVvalue can instead be adjusted before computing the stress level inalternative example embodiments so that the stress computation isindirectly adjusted to compensate for noise.

Particular embodiments may repeat one or more steps of the method ofFIG. 11, where appropriate. Although this disclosure describes andillustrates particular steps of the method of FIG. 11 as occurring in aparticular order, this disclosure contemplates any suitable steps of themethod of FIG. 11 occurring in any suitable order. Moreover, althoughthis disclosure describes and illustrates an example method fordetermining a health-variability measurement of a user including theparticular steps of the method of FIG. 11, this disclosure contemplatesany suitable method for determining a health-variability measurement ofa user including any suitable steps, which may include all, some, ornone of the steps of the method of FIG. 11, where appropriate.Furthermore, although this disclosure describes and illustratesparticular components, devices, or systems carrying out particular stepsof the method of FIG. 11, this disclosure contemplates any suitablecombination of any suitable components, devices, or systems carrying outany suitable steps of the method of FIG. 11.

Post-Hoc Data Processing

In particular embodiments, post-hoc data process may entail usingsensors to get a bird's eye view of a user's health. In a sensor-basedhealth care monitoring system, one usage may be to provide daily summaryand analysis of recorded data to educate and motivate the user about hishealth status. However, deeper insights may require clean data,especially to analyze subtler nuances. Since motion artifacts and noisysignal are difficult to resolve, most summaries provided to usersinclude a number of errors (e.g., especially in the case ofartifact-sensitive measurements such as HR and HRV). In areas of stressand ANS monitoring, such noise may mask critical moments, and the lossin accuracy may be enough to result in many types of 24×7 monitoringsystems being impractical. As such, methods described below are foridentifying and removing noisy signals (e.g., noisy HRV or RR-Deltadata) from sensor data using dimension analysis.

As discussed above with regard to FIG. 10, post-hoc noise analysis model1012 may receive a history of past health values and various baselinevalues (e.g., corresponding to PPG data, PPG derivatives such as RR andRR-Delta, and the like) as inputs and provides post-hoc noise analysisas an output. For example, during operation, post-hoc noise analysismodel 1012 may store the computed health measurements from real-timehealth monitor module 1006 in health database 1014. Accordingly, overtime post-hoc noise analysis model 1012 may generate a history of pasthealth values and baseline values that can be used to perform post-hocanalysis.

Post-hoc analysis may correspond to, e.g., updating health measurements,updating noise models of real-time noise quantification module 1004 andhealth-error module 1008, other relevant post-hoc analyses, or anycombination thereof. In particular embodiments, post-hoc noise analysismodel 1012 may perform post-hoc analysis by parsing and saving real-timePPG data and PPG derivative data and then performing chaotic nonlinearanalysis on the parsed and saved data, as described below.

The computed health measurements that post-hoc noise analysis model 1012receives as input from real-time health monitor module 1006 maycorrespond to PPG data, PPG derivatives such as beat-to-beat heart rate(RR) and beat-to-beat heart-rate variability (RR-Delta), other relevantinputs, or any combination thereof. In particular embodiments, computedhealth measurements may correspond to any suitable sensor datarepresentative of biomeasurements as well as computed values derivedfrom such biomeasurements (e.g., a stress level). Post-hoc noiseanalysis model 1012 may parse and analyze a segment of the input (e.g.,which may be stored in health database 1014) to determine a systemdimension of the input. The system dimension may correspond to a valuethat is indicative of the level of noise in the parsed segments. Oncethe level of noise is quantified in a parsed segment, the confidence ofcomputed real-time stress values can be reevaluated for correction orremoval.

During post-hoc analysis processing, post-hoc noise analysis model 1012may store the history of past health values and various baseline valuesas an embedding dimension when there is convergence and as a noiseindicator when there is no convergence. More specifically, the parsedsegments may each have a tag associated to them. The tag may becomprised of a beginning timestamp, an ending timestamp, an embeddingdimension, and the results of a dimensional convergence test (e.g.,indication of the fact that there was convergence). In particularembodiments, only higher-order physiological data is stored in theoffline database, thereby facilitating efficient storage and dataperformance. The RR-Delta, timestamps, and embedding dimension valuesmay be stored for offline processing. In particular embodiments, thisdatabase may be synced periodically (e.g., once a day), as this processmay operate on a longer time scale than the normal stress processing.

As stated, post-hoc noise analysis model 1012 may process the history ofpast values offline in a post-hoc manner. As an example and not by wayof limitation, post-hoc noise analysis model 1012 may be configured toprocess the history of data stored in the health database 1014 inresponse to a trigger condition. The trigger condition may be based on anumber of conditions. As an example and not by way of limitation, thetrigger condition may be time based, such as periodically triggeranalysis every day, week, month, other suitable time frame, or anycombination thereof. Additionally or alternatively, the trigger may beevent based, such as a state of the device (e.g., a charging state, atransition to a charging state, a power-on state, etc.), a state of useractivity (e.g., extreme noise beginning or end, for example, indicatedby accelerometer integrated signal, a period of extreme stress, a sleepstage, a manual user request, etc.), a state of the history data (e.g.,an amount of stored measurements for post-hoc processing, long-termstress measurement trends, frequency of stress processor use, frequencyof previous noise detection, time since last update, etc.), otherrelevant state, or any combination thereof.

In particular embodiments, post-hoc noise analysis model 1012 mayprocess the history of past health values and various baselines toseparate noise out of the sensor data. Because of the post-hoc nature(e.g., no real-time constraints), the post-hoc noise analysis model 1012may utilize a signal model having higher order dynamics and/or complexcharacterstics that may be too computationally expensive for real-timeanalysis. For instance, in an example embodiments, post-hoc noiseanalysis model 1012 may be configured to identify chaotic signalbehaviors from noise, thereby increasing the accuracy of the noise modeland the computed health measurements. A method for processsing thehistory data to generate the post-hoc analysis, in accordance with anexample embodiment, is described in more detail below.

First, the health measurement data may be transformed from simpletime-series representation to a phase space representation. That is,each point in a segment of the time series may be taken to be aparticular element in a larger vector X(t) whose magnitude and directionrepresent a point in the collection of all possible states. By parsingthe time-series history segments into unique vectors in phase space, thespace itself may be constructed:

X(t)=[X(t),X(t+τ), . . . ,X(t+(m−1)τ]

The variable τ represents a system delay that is to be determined. For agiven system delay τ, the mutual information MI can be computedaccording to the following equation:

${{MI}(\tau)} = {\sum\limits_{{x{(i)}},{x{({i + \tau})}}}{{P\left( {{x(i)},{x\left( {i + \tau} \right)}} \right)}\log_{2}\frac{P\left( {{x(i)},{x\left( {i + \tau} \right)}} \right)}{{P\left( {x(i)} \right)}{P\left( {x\left( {i + \tau} \right)} \right)}}}}$

The post-hoc noise analysis model 1012 may search for the system delay τthat results in the first minimum value of mutual information. Detailsof how to evaluate the probability functions P are provided below inaccordance with an example embodiment.

After determining the system delay τ from mutual information, post-hocnoise analysis model 1012 may separate and reconstruct the attractorgoverning the physiological signal. As an example and not by way oflimitation, as the embedding dimension is increased, the computedcorrelation dimension levels off for low-dimensional chaotic time seriesdata. For purely stochastic time series data, the correlation dimensionshould continue to increase. With these two cases, the stochastic andchaotic signals may be discriminated based on the trends of MI withrespect to system delay τ. This may be computed by calculating theentropies and joint entropies of the system.

Given this embedding dimension, post-hoc noise analysis model 1012 maycompute a correlation dimension. As an example and not by way oflimitation, post-hoc noise analysis model 1012 may compute a correlationdimension by assuming a power-law dimensional form, calculating thepoint-wise dimension, and extrapolating this to the correlationdimension. In particular embodiments, the power-law dimensionalityfunction may take the following form A(ε)∝ε^(d), where ε is the radiusof the circle surrounding the vectorized points in the time-series. ThisA(ε) calculation is now performed around the points in the time seriesand the results are averaged to transform point-wise dimension tocorrelation dimension, called C_(x). At large values of ε and smallvalues of ε there should be flat curves of C_(x) because eventuallycircle leaves the attractor and there are no more points to be added, orshrink the sphere sufficiently to only have space for one point (e.g.,the center of the circle in 2D). However, in-between these two limitsthere should exist a relatively constant line (e.g., plotted in log(ε)v. log(C_(x)) space).

This processing may be done for a single system-embedding dimension. Inalternative example embodiments, proper detection of the attractor maybe performed by measuring a convergence of embedding dimension. Thisconvergence may be visually seen from an example use of this algorithmin FIG. 13. In FIG. 13, the embedding dimension may be increased in thedirection of the arrow. The convergence in embedding dimension may beseen as the slopes of these curves approaching the same value.

Highly stochastic signals may have infinite dimensionality since eachdimension has noise distribution present; the stochasticity leads toinfinite degrees of freedom. Chaotic signals reach a certain point wherefurther increasing the system-embedding dimension has no effect on thecorrelation dimension. At this point, the attractor is said to be“disentangled.” Distinguishing stochasticity from chaotic determinism,the correlation dimension stabilizes as the embedding dimension issequentially increased. Otherwise, the signal is stochastic.

The discrete steps of the above-described method, in accordance withparticular embodiments, are described in more detail below.

This method may include the use of mutual information (MI) anddimensional embedding for chaotic signals. MI is indicative of theaverage amount of bits of data a given measurement X(t) gives aboutanother measurement X(t+τ) at a later time. In other words, MI maycorrespond to the average amount of information (in bits) that onerandom variable (e.g., X(i)) gives about another (e.g., X(i+τ)), whichcan be written into the following equation form:

${{MI}(\tau)} = {\sum\limits_{{x{(i)}},{x{({i + \tau})}}}{{P\left( {{x(i)},{x\left( {i + \tau} \right)}} \right)}\log_{2}\frac{P\left( {{x(i)},{x\left( {i + \tau} \right)}} \right)}{{P\left( {x(i)} \right)}{P\left( {x\left( {i + \tau} \right)} \right)}}}}$

The above equation implies high MI for a delay corresponding a multipleof a period of a periodic signal. While increasing the delay τ, MIbegins relatively high since the two data sets being compared are notdelayed (e.g., different) by very much. More specifically, X(t) gives alot of information about X(t+τ) when τ is small, and therefore means MIis high in this same area. As τ gets larger, there is less informationthe non-delayed measurement X(t) gives about a later one. This drop inMI continues until the delay corresponds to the periodicity of thesignal (if periodicity is present). For PPG type-data, the signals maycorrespond to chaotic-based signals coupled to period signals, andpost-hoc noise analysis model 1012 may separate the periodicity from thechaotic markers. To do this, post-hoc noise analysis model 1012 mayevaluate MI as τ is increased and select the delay τ that produces thefirst minimum value of mutual information is chosen. This allows fordata points X(t) and X(t+τ) to be somewhat decoupled, but not entirelyindependent. The process, in accordance with an example embodiment, isdescribed below as Steps 1-9.

Step 1. A window of data (RR-Delta samples) is saved for analysis.Post-hoc noise analysis model 1012 may store the data as an array in thedatabase 1014. The size of the array should be sufficiently large sincethe finer points of the signal do not matter for long-term signals. Thesize of the array may be selected based on a number of considerations.In particular embodiments, the size of this array may be similar to thefeature being detected. One example size for this array is 400 samples,which corresponds to approximately 8 minutes of stress monitoring.However, if the number of samples available is less than this, thealgorithm can proceed with fewer numbers of samples. The delayed x(t+τ),. . . , x(t+(m−1)τ points are generated from this array of data.

Step 2. The data array x is delayed by τ (as τ changes from 1 to N) intoN arrays. Each array point may be compared to the original array.

Step 3. Once these arrays are generated, the MI is calculated between xand x(t+τ). This is then stored in an array for MI in order ofincreasing r.

To calculate average mutual information, post-hoc noise analysis model(12 may perform the following operations:

(I). Normalize X and vertically shift the data to begin at zero bysubtracting the minimum value and then dividing by the maximum value.

x_(i)^(*) = ∑x_(i) − x_(min)${\hat{x}}_{i} = \frac{x_{i}^{*}}{x_{\max}^{*}}$

(II.) Delay the data in {circumflex over (X)} by τ and call this Ŷ. Ŷ isa delayed-image of {circumflex over (X)} and then delayed-phase portraitis what the mutual information calculation is performed on.

(III.) Define how many bins to break the distribution functions into.Since this is a 2-dimensional portrait of {circumflex over (X)}Ŷ, thepartitions are 2D box partitions. The size of the bins may be selectedbased on the application. Additionally, the size of the bins may befixed or can vary adaptively. In particular embodiments, the bin sizemay selected based on the following equation:

$n = \left\lfloor {1 + {\log_{2}\left( {N - \tau} \right)} + \frac{1}{2}} \right\rfloor$

The equation implies that there are N² boxes in this phase portrait.Here, N is the length of {circumflex over (X)} and Ŷ.

(IV.) Check for variance. If the variance is approximately zero, thenthe MI would be approximately zero. In particular embodiments, this stepmay be omitted.

(V.) Define box-search variables s₁ and s₂. Here, a specific boxcorresponds to a point (s_(1i), s_(2j)). These are now each traversedfor every instance of τ. This may be performed using a nested for-loopin implementation. For example, s₂ can be a partition along theinner-horizontal axis of phase space and s₁ can be a partition along theinner-vertical axis.

Define probability distributions p, p_(x) and p_(y). These three valuesare the joint probability distribution, probability distribution of{circumflex over (X)} and probability distribution of Ŷ respectively.Find instances of {circumflex over (X)} that satisfy the followingconditions.

${{C_{1}\text{:}\mspace{14mu} \frac{\left. {s_{l_{i}} - 1} \right)}{n}} < {\hat{x}}_{k}};$with {k = 1, 2, …  n − τ}${{C_{2}\text{:}\mspace{14mu} \frac{s_{1_{i}}}{n}} \geq {\hat{x}}_{k}};$with {k = 1, 2, …  n − τ}${{C_{3}\text{:}\mspace{14mu} \frac{\left( {s_{2_{j}} - 1} \right)}{n}} < {\hat{x}}_{k}};$with {k = 1 + τ, 2 + τ, …  n}${{C_{4}\text{:}\mspace{14mu} \frac{s_{2_{j}}}{n}} \geq {\hat{x}}_{k}};$with {k = 1 + τ, 2 + τ, …  n} And$C_{s_{1_{i}},s_{2_{j}}} = {{1\mspace{14mu} {if}\mspace{14mu} {all}\mspace{14mu} C_{p}\mspace{14mu} {are}\mspace{14mu} {{true}.G_{s_{1_{i}},s_{2_{j}}}}} = {{1\mspace{14mu} {if}\mspace{14mu} {both}\mspace{14mu} C_{1}\mspace{14mu} {and}\mspace{14mu} C_{2}\mspace{14mu} {are}\mspace{14mu} {{true}.F_{s_{1_{i}},s_{2_{j}}}}} = {{1\mspace{14mu} {if}\mspace{14mu} {both}\mspace{14mu} C_{3}\mspace{14mu} {and}\mspace{14mu} C_{4}\mspace{14mu} {are}\mspace{14mu} {{true}.p}} = \frac{\sum_{s_{1_{i}} = 1}^{n}{\sum_{s_{2_{j}} = 1}^{n}C_{s_{1_{i}},s_{2_{j}}}}}{N - \tau}}}}$$p_{x} = \frac{\sum_{s_{1_{i}} = 1}^{n}{\sum_{s_{2_{j}} = 1}^{n}G_{s_{1_{i}},s_{2_{j}}}}}{N - \tau}$$p_{y} = \frac{\sum_{s_{1_{i}} = 1}^{n}{\sum_{s_{2_{j}} = 1}^{n}F_{s_{1_{i}},s_{2_{j}}}}}{N - \tau}$

(VI.) Calculate the final MI given the probability probabilitiescalculated above. For instance, this calculation may be approximatelyequivalent to the equation:

${{MI}(\tau)} = {p*\log_{2}\frac{p}{p_{x}p_{y}}}$

(VII.) This calculation may repeated for a number of values of τ toobtain a distribution of MI over multiple delays.

Step 4. Detect a peak in the array of MI for various delays.Specifically, the local peaks (corresponding to mutual informationminimum) are being sought. These are the τ that correspond to Δt whosefrequency transform gives the periodic-decoupled RR-Deltas.

Step 5. Determine the point-wise dimension. This may be done forincreasing values of m as defined in the following equation.

X(n)=[X(n),X(n+τ), . . . ,X(n+(m−1)τ]

That is, post-hoc noise analysis model 1012 may increment through valuesof m and perform point-wise dimension calculations on each. Here, X(n)is a vector in m-dimensional space that represent a single point in thephase space of the system. Increasing n is the direction of propagationalong a phase-space trajectory. Post-hoc noise analysis model 1012 mayselect a value of n and parses the input function X(t) into vectorslength m. Then post-hoc noise analysis model 112 may calculate thenumber of neighboring points at a given radius (ε) from each point(X(n)) in this phase-space. This value is then averaged over all pointsand then ε is increased one step and the counting and averaging isperformed once again. As stated above, post-hoc noise analysis model1012 may use the model that the counted number of points isexponentially proportional with the following form.

A(ɛ) ∝ ɛ^(d) ${C_{x}(ɛ)} = \frac{\sum_{ɛ}A}{N}$

In this manner, C(ε) may be calculated as a discrete function of ε.

Step 6. To obtain the embedding dimension d, post-hoc noise analysismodel 1012 may apply an algorithm function on each side of thisproportionality and then solve for d.

$d = \frac{\ln \mspace{14mu} C_{x}}{\ln \mspace{14mu} ɛ}$

Step 7. Steps 5 and 6 may be repeated for increasing values of m.

Step 8. The convergence is tested from m=2 to m=m_(min). The value ofm_(min) can depend on the length of samples in the data storage bufferin example embodiments. If the slope continues to change more than athreshold value Δd_(thresh), then the data is tagged as being noisy andthese values of RR-Delta are removed from the stress calculation, whichis then redone without these values.

Step 9. The values of d_(converge), which is the value of d afterconvergence has been verified will be saved for future analysis ofphysiological significance.

Noise Prediction and Signal Stitching/Replacement

In particular embodiments, a method to correct a noisy signal (e.g., aPPG signal) may be based on the observation that jitters or signaldistortions can be local to peak or trough or zero-crossings. For signaldistortions near signal maxima, minima, or zero-crossings, the noise maybe estimated by first computing the expected signal profile, and thenblending a constructed signal determined based on the expected signalprofile with the raw signal. In the case of high signal distortions, therelevant portion of the signal may be completely thrown out and replacedby the constructed signal determined based on the expected signalprofile. This way, the method results in providing a good PPG signalwith low noise to the user for use and analysis. In addition, incomparison with the post-hoc analysis discussed above, the methods forstitching and/or replacing noisy signals discussed below may be done inreal-time and very quickly in order to output a relatively noise-freesignal to the user.

As discussed above, as shown in FIG. 9, at step 916, health monitoringsystem 200 may determine whether statistical prediction is possible. Inparticular embodiments, health monitoring system 200 may determinewhether statistical prediction is possible by looking at the statisticalproperties of prior PPG signals, and then based on this information,determine whether it is possible to reconstruct one or more missingpieces of a signal with reasonable accuracy. However, if the prior PPGsignals are determined to be pure noise, then health monitoring system200 may determine that no information may be extracted to help build themissing signal, and thus the reconstruction or prediction of the signalis also not possible. In other words, if it is determined at step 916that signal prediction is possible (e.g., a determination of “YES”),then health monitoring system 200 may move to step 918 to perform signalprediction and adjust the received signal based on the predicted signal,and then to step 920 to reduce the effect of the noise. On the otherhand, if it is determined at step 916 that signal prediction is notpossible (e.g., a determination of “NO”), then health monitoring system200 may move to step 922 to perform noise compensation by usingnoise-error plots. In addition, as illustrated in FIG. 10, the sensordata may be inputted into real-time noise quantification module 1004,which may determine a noise level of the sensor data, and real-timehealth monitor module 1006, which may generate a health measurementafter compensating for the noise in the sensor data.

FIGS. 14A-C illustrate a noise correction system 1400 for noiseprediction and signal stitching or replacement. Noise compensationsystem 1400 (e.g., of health monitoring system 200), which may beexecuted via real-time noise quantification module 1004 and/or real-timehealth monitor module 1006, may initially receive an input of rawsignals 1410. As discussed above, raw signals 1410 may be received fromthe sensor (or sensor interface) 1002. Raw signals 1410 may be processedthrough basic filtering and feature extraction 1420. As an example andnot by way of limitation, the raw signals 1410 may be processed throughbasic filtering to remove a portion of noise (e.g., any blocks of theraw signals with a frequency greater than 15 Hz) and to remove unwantedDC offsets and low-frequency oscillations. In addition, the raw signals1410 may be processed with a multi-band filter bank such that peak,trough, and zero-crossing times may be extracted from the signal, andthis information may be stored for later use (e.g., to determine whethera signal is noisy or not). During the signal processing of a PPG signal,some embodiments may look for signal peaks at expected locations. In thesituation of high heart rate obtained due to sudden exertion such asexercise, the embodiments that look for signal peaks at expectedlocations may provide erroneous results since the expected signalbehavior has changed dramatically, and often suddenly; for example, asthe heart rate increases from 5 BPM to 100 BPM and then onwards to 200BPM. Particular embodiments may adjust to the dramatic changes in PPGprofile by carrying average signal profiles (for example, RR-intervalsor first or second derivative of rate of change in the signal). Thisinformation is kept both in terms of a local signal (that is, signalaround an expected heart beat) as well as a global signal (that is,signal around several heart beats) around the given locality. Thisallows particular embodiments to do local processing in cognizance ofthe global trend. For example, if the global features seem to beindicating that the heart rate seems to be generally speeding up, thenthe local signal processing parameters may be correspondingly adjustedaccordingly (e.g., so that particular embodiments look for a possiblesignal feature (such as signal peak) at an earlier point in time).

The time-lagged mutual information block 1422 may compute a time-laggedmutual information output on an array of PPG samples from the filteredraw signal. For example, X(t) can represent an array of N>0 PPG samplesoutputted by the basic filter and peak detection 1420. The time-laggedmutual information block 1422, in accordance with example embodiments,computes a mutual information output MI(τ) for a delay r, e.g., asdescribed above in connection with the post-hoc analysis model 1012,using the array of N PPG samples.

The peaks of this distribution MI(τ) may provide features present in thePPG signal. One of these features may be heart rate (which, e.g., ispseudo-periodic). For instance, a delay r that results in a peak of Mcan correspond to a HR estimate.

An example benefit, among others, of an example embodiment of using MIfor HR calculation is that it can facilitate noise immunity since theself-similarity may not be dramatically reduced by noise at anyremarkable point in the PPG morphology (such as zero crossing or peak).Additionally, it may provide a robust method to determine the range inwhich the HR lies so that the outliers can be more easily removed. Thus,confounders in HR due to noise but posing as RSA based variation can bemore easily identified. As such, mutual information approach may be morenoise-resilient to different types of noise than the other waveformfeatures.

With further reference to FIGS. 14A-C, the filtered raw signal may besent to noise quantification system 1430. Noise quantification system1430 may include a signal delay 1432, a signal filter 1436, a data gate1438, a noise detector 1440, and a waveform buffer 1446. In particularembodiments, the filtered raw signal may be sent to signal delay 1432,where the delay-filtered signal 1434 may be sent to both signal filter1436 and data gate 1438. In particular embodiments, signal delay 1432may store and maintain the filtered raw signal for a predeterminedperiod of time before passing the delay-filtered signal 1434 to datagate 1438 so that the delay-filtered signal 1434 sent to signal filter1436 may be analyzed by noise detector 1440 to determine whether noiseis present (e.g., so that the noise may be detected and handled inapproximately real-time). In determining whether noise is present, noisedetector 1440 may compute relative pulse width and pulse amplitudes(e.g., between a first pulse and one or more second subsequent pulses)and compare with physiologically acceptable deviations, and metricchanges greater than the physiologically acceptable deviations may beconsidered to be noise. As an example and not by way of limitation, fora PPG waveform signal, signal delay 1432 may maintain (e.g., “delay”)the filtered raw signal for a period of about 100 samples, whichcorresponds to about a single pulse of a heartbeat. This way, if it isdetermined that the filtered raw signal contains noise, then noisecorrection system 1400 may go back to the beginning of the single pulse(e.g., located somewhere in the 100 samples) and correct the filteredraw signal before the noise occurs. In particular embodiments, for thePPG waveform signal, the beginning of the single waveform may be a peak(e.g., where the single pulse is determined based on a pulse-peak to thenext pulse-peak), a trough (e.g., where the single pulse is determinedbased on a trough to the next trough), a zero-crossing (e.g., where thesingle pulse is determined based on a zero-crossing to the nextzero-crossing), other relevant waveform feature, or any combinationthereof. Particular waveform features and advantages of specificwaveform features are discussed in more detail below.

Once noise detector 1440 determines whether or not noise is present inthe delay-filtered signal 1434, this determination is sent to data gate1438 in addition to being sent to a blender 1462. If it is determinedthat there is no noise (e.g., step 1442), then the delay-filtered signal1434 is saved and inputted into a waveform buffer 1444, while also beingsent to blender 1462 (discussed below). In particular embodiments,waveform buffer 1444 (e.g., a memory buffer) may store only apredetermined amount of data. As an example and not by way oflimitation, for the PPG waveform signal, waveform buffer 1444 may storeonly data corresponding to three pulses of heartbeats (e.g., N=3).Waveform buffer 1444 may be configured to store a small number of pulsessuch that noisy signals (e.g., pulse signals with large deviations inone or more features as compared with one or more previous pulsesignals) may be determined to noisy in comparison with previous signalsbut at the same time allowing for gradual changes in the signal. Inaddition, when waveform buffer 1444 starts with nothing in the buffer(e.g., no PPG waveforms stored), the initial determination will be thatthe delay-filtered signal does not contain noise such that at leastthree PPG pulses may be stored before analyzing the waveform of apresent PPG pulse with the waveform of a previous PPG pulse. Then, afterthere are three non-noisy PPG waveforms stored in waveform buffer 1444,each additional PPG waveform that is determined to not be noisy is savedto waveform buffer 1444 while an old PPG waveform (e.g., the PPGwaveform from four pulses ago) will be removed. This way, waveformbuffer 1444 may always maintain the last three PPG waveformscorresponding to the last three pulses.

In particular embodiments, the number of pulses stored in waveformbuffer 1444 may be small enough to allow for meaningful comparison andalso may be large enough to average out inter-pulse deviations andnoise. As an example and not by way of limitation, three pulses ofheartbeats is stored in waveform buffer 1444 due to the phenomenon ofrespiratory sinus arrhythmia (RSA), which is heart-rate variability insynchrony with respiration, by which the R-R interval on an ECG isshortened during inspiration and prolonged during expiration. The effectof RSA on the PPG waveform is such that inhalation gradually increasesthe HR while decreasing the PPG waveform amplitude, whereas exhalationgradually decreases the HR while increasing the PPG waveform amplitude.In particular embodiments, the effect of RSA on the PPG waveform may befactored into and separate from the determination of noise in the PPGwaveform (e.g., N=3 is chosen to fall within the known RSA cycle).

On the other hand, if it is determined that there is noise present inthe delay-filtered signal 1434 (e.g., step 1446), then as shown in FIGS.14A-C, then noisy data 1456 is sent to delay 1458 of a waveform builder1450. In particular embodiments, waveform builder 1450 may include astatistics engine 1452, delay 1458, and blender 1462. In particularembodiments, the delay-filtered signal 1434 processed through waveformbuffer 1444 is inputted into statistics engine 1452, which thengenerates a statistical waveform 1454 based on the data stored inwaveform buffer 1444 (e.g., the last 3 pulses), and the data may also beadjusted to match the changing period of the signal to allow for bettersignal matching as the PPG waveform signal goes from noisy to clean andthe statistical waveform 1454 is transitioning to real-time data. Thisstatistical waveform 1454 is then sent to blender 1462. In addition,noisy data 1456 is inputted into delay 1458, where it is stored for apredetermined amount of time such that the statistical waveform 1454 maybe generated by statistics engine 1452 (e.g., allowing for signalcorrection in approximately real-time). Then, delay-noisy data 1460 andthe statistical waveform 1454, in addition to the determination fromnoise detector 1440 and the delay-filtered signal 1434 (e.g., output bydata gate 1438), are inputted into blender 1462. Blender 1462 may thenblend the statistical waveform 1454 (e.g., the constructed waveform)with the delay-filtered signal 1434 (e.g., the raw-signal waveform) whennoise is detected in the delay-filtered signal 1434. As an example andnot by way of limitation, the blending may include beginning with zerostrength (e.g., 0%) given to the constructed waveform and 100% strengthgiven to the raw-signal waveform at the point nearest to the a selectedfeature (e.g., the zero-crossing, the peak, or the trough), and thenprogressively weighing the constructed waveform more heavily until thesignal is 100% constructed waveform and 0% raw-signal waveform. Inaddition, this process may be gradually done in reverse to merge twosignals after noise is no longer detected in the signal. In particularembodiments, the resultant blended signal may then be sent through anadditional filter to ensure points on the waveform are smoothly blendedinto this resultant, blended signal. Then, blender 1462 may outputnoise-compensated data 1464 (e.g., a noise-compensated signal), to apulse corrector 1470.

As shown in FIGS. 14A-C, pulse corrector 1470 may include a heart rate(HR) calculator 1472, a RSA interpolator 1474, a RSA quality check 1480,and an OR gate 1486. The purpose of pulse corrector 1470 is to take intoaccount the RSA cycle when suggesting the HR in the presence of thenoisy signal, which may be done using quadratic interpolation of the HRsignal. First, noise-compensated data 1464 is inputted into HRcalculator 1472 to determine a heart-rate signal based on thenoise-compensated data 1464. Then, the heart-rate signal determined viaHR calculator 1472 is sent to RSA interpolator 1474. In particular, foreach feature that heart rate is calculated on (trough, peaks, etc.), theheart rate (HR Calculator 1472) may be sent first into a time (sample)median filter and then to a moving average filter (collectively shown inFIGS. 14A-C as a time-median/mean filter 1466) to reduce outlierpresence. The RSA interpolator 1474 may calculate a quadratic-fit signal1476 (e.g., an interpolated RSA-estimate), and compare that with anoise-compensated HR signal 1478 via RSA quality check 1480. If it isdetermined that the quadratic-fit signal 1476 deviates from thenoise-compensated HR signal beyond a predetermined amount (e.g., athreshold amount of acceptable deviation), that is, if it is determinedthat the noise-compensated HR signal 1478 is of poor quality, then aquadratic average signal 1482 is calculated based on both thequadratic-fit signal 1476 and the HR noise-compensated HR signal 1478,and this quadratic average signal 1482 is outputted via OR gate 1486 asthe corrected output 1490 (e.g., an outputted signal that is correctedin approximately real-time). On the other hand, if it is determined thatthe quadratic-fit signal 1476 does not deviate from thenoise-compensated HR signal beyond the predetermined amount, then thenoise-compensated HR signal 1484 is outputted via OR gate 1486 as thecorrected output 1490. In particular embodiments, the threshold amountof acceptable deviation may depend on the circumstances. As an exampleand not by way of limitation, when no noise is detected, the maximumallowable deviation between a first set of data and a second, subsequentset of data may be 15%. However, when noise is detected, the maximumallowable deviation between the first set of data and the second,subsequent set of data may be decreased to 5%. For each feature thatheart rate is calculated on (trough, peaks, etc.), the heart rate(Corrected Output 1490) may sent first into a global feature-medianfilter and then to a moving average filter (collectively shown in FIGS.14A-C as a global feature median filter 1492) to reduce outlierpresence. The global feature-median filter 1492 may contain synchronizedfinal corrected outputs from the processing blocks of heart rate fromtrough, peak, pulse-corrected locations and mutual information.

Particular embodiments may repeat one or more steps of the method ofFIGS. 14A-C, where appropriate. Although this disclosure describes andillustrates particular steps of the method of FIGS. 14A-C as occurringin a particular order, this disclosure contemplates any suitable stepsof the method of FIGS. 14A-C occurring in any suitable order. Moreover,although this disclosure describes and illustrates an example system andmethod for noise prediction and signal stitching or replacementincluding the particular systems and steps shown in FIGS. 14A-C, thisdisclosure contemplates any suitable systems and method for noiseprediction and signal stitching or replacement including any suitablesystems and steps, which may include all, some, or none of the systemsand steps of the method of FIGS. 14A-C, where appropriate. Furthermore,although this disclosure describes and illustrates particularcomponents, devices, or systems carrying out particular steps of themethod of FIGS. 14A-C, this disclosure contemplates any suitablecombination of any suitable components, devices, or systems carrying outany suitable steps of the method of FIGS. 14A-C.

Feature Detection and Analysis

As discussed above, as shown in FIG. 9, at step 910, health monitoringsystem 200 may determine whether peak detection of the received signalis possible. As an example and not by way of limitation, healthmonitoring system 200 may attempt to determine peaks of the sensorsignal having certain properties such as a well-formed morphology thathave repeated and detectable features in each cycle (e.g., asinusoidal-type signal in the proximity of the peak in a PPG signal). Ifit is determined at step 910 that peak detection is possible (e.g., adetermination of “YES”), health monitoring system 200 may proceed tostep 912, where health monitoring system 200 may perform peak detection.Then, based on the detected peak information, at step 914, healthmonitoring system 200 may determine signal features for a healthalgorithm (e.g., a stress algorithm).

The method for accurate peak detection is based on the observation thateven though a signal may be distorted, some aspects of it might still beamenable to analysis. These can be the peak, the trough, or thezero-crossing points (e.g., where the signal during its rising orfalling edge cross the zero line), as discussed below with regard toFIG. 15, which illustrates an example signal according to particularembodiments of this invention. As an example and not by way oflimitation, ambiguous peak positions may result in errors in thedetection of these peaks and errors in calculations using thesemeasurements (e.g., inaccurate determinations of heart rate and stresslevels). As another example and not by way of limitation, the point ofmaximum slope (e.g., the zero-crossings of detrended PPG signals) may bemore robust to errors. In particular embodiments, each of the peaks,troughs, or zero-crossings may be approximated by quadratic fitting(e.g., near peaks or troughs) or linear fitting (e.g., nearzero-crossings). Once the approximation is done, the extent of noise maybe calculated by calculating the deviation of the approximated graph(e.g., based on the approximated points) with the signals generated(e.g., the received raw signals).

FIG. 16 illustrates an example method 1600 for detecting and analyzingsignal features based on particular embodiments of this invention. Themethod may begin at step 1610, where health monitoring system 200 mayanalyze noise at predetermined features of a PPG signal. At step 1620,health monitoring system 200 may determine whether one or more of thefeatures have been corrupted by noise. At step 1630, health monitoringsystem 200 may compute the RR intervals based on one or more of thefeatures that are not noisy.

An example of signal feature detection and analysis is explained usingPPG signals and FIG. 15. In particular embodiments, quantifying anamount of noise of the PPG signal may include quantifying an amount ofnoise associated with each of a plurality of predetermined features ofthe PPG signal. As discussed below, the plurality of predeterminedfeatures of the PPG signal may include one or more peaks associated withthe PPG signal, one or more troughs associated with the PPG signal, oneor more zero-crossings associated with the PPG signal, or anycombination thereof. In particular embodiments, PPG signals may beacquired from the user's wrist at different sampling rates using asensor platform containing LEDs and photodetectors (e.g., as part ofhealth monitoring system 200). Data received from health monitoringsystem 200 may be digitized at varying frequencies, for example, rangingfrom 25 Hz to 800 Hz. FIG. 15 illustrates an example signal according toparticular embodiments of this invention. As shown in FIG. 15, anexample PPG signal 1500 may include peaks 1510, troughs 1520,zero-crossings 1530, and RRs 1540 (heart beat-to-heart beat intervals).The plot may contain 4 seconds of PPG signals sampled by healthmonitoring system 200 via the user's wrist. As an example and not by wayof limitation, as shown in FIG. 15, a time series of the PPG signals maycontain a number of peaks (e.g., 4 peaks) and the PPG signalmorphological features may change between each of the peaks.

In particular embodiments, health monitoring system 200 may selectivelyuse features of the PPG signal based on the noise level determined foreach feature. In addition, the signal in the vicinity of each featuremay be analyzed to determine whether noise is present to determinewhether the feature is a reliable feature. As an example and not by wayof limitation, if health monitoring system 200 determines that a peak ofthe PPG signal is noisy, health monitoring system 200 may calculate theRR interval not from a first peak to a second, subsequent peak, but froma zero-crossing to a subsequent zero-crossing. In other words, healthmonitoring system 200 may analyze all features associated with a signalto select one or more features to use in signal analysis based on thenoise in one or more of the features, and also discard any feature thatare determined to be noisy.

Particular embodiments may repeat one or more steps of the method ofFIG. 16, where appropriate. Although this disclosure describes andillustrates particular steps of the method of FIG. 16 as occurring in aparticular order, this disclosure contemplates any suitable steps of themethod of FIG. 16 occurring in any suitable order. Moreover, althoughthis disclosure describes and illustrates an example method fordetecting and analyzing signal features including the particular stepsof the method of FIG. 16, this disclosure contemplates any suitablemethod for detecting and analyzing signal features including anysuitable steps, which may include all, some, or none of the steps of themethod of FIG. 16, where appropriate. Furthermore, although thisdisclosure describes and illustrates particular components, devices, orsystems carrying out particular steps of the method of FIG. 16, thisdisclosure contemplates any suitable combination of any suitablecomponents, devices, or systems carrying out any suitable steps of themethod of FIG. 16.

Continuous Biological Measurements and Alarm Fatigue Proof Features

As discussed above, stress is considered to be one of the largestcontributors to various health problems. Technology for stressmonitoring may focus on providing real-time instantaneous measurementsof stress. However, stress measurements may be meaningful only in thecontext of chronic and prolonged stress, as short term spikes in stress,unless extremely sharp and unusual, are not very significant to theuser's health. In fact, frequent alerts of short term stress event mayresult in “alarm fatigue” in which the user becomes desensitized to thestress notifications and begins to ignore the alarms altogether.Moreover, continuous monitoring for chronic stress requires consuming alot of power, and therefore is difficult to implement based on the powerconstraints of wearable electronic devices. Accordingly, particularembodiments discussed below address the issues described above tofacilitate accurate, meaningful measurement of psychological stress thatis also performed in a power efficient manner. As an example and not byway of limitation, particular embodiments detect signs of relativelylonger term disturbances in stress homeostasis. In addition, particularembodiments focus on such measurements in the context of monitoring andmanagement of health and/or wellness that are both well-suited forbio-sensing and power efficiency (e.g., by a factor of at least 4) whileconsidering a user-specific context of the measurement and/or auser-specific baseline of the given user.

FIG. 17 illustrates an example general method 1700 for continuous andpower-efficient monitoring of a user's stress level based on biologicalmeasurements of the user. The method begins at step 1710, where healthmonitoring system 200 may analyze sensor data, as described in moredetail below with respect to particular embodiments. At step 1720,health monitoring system 200 may analyze heart rate and activity, asdescribed in more detail below with respect to particular embodiments.At step 1730, health monitoring system 200 may analyze stress and LHPAaxis activation, as described in more detail below with respect toparticular embodiments. At step 1740, health monitoring system 200 mayanalyze user preference and interaction, as described in more detailbelow with respect to particular embodiments. Then, at step 1750, healthmonitoring system 200 may reduce alarm fatigue reduction and sampleand/or monitor in a power efficient and continuous manner, as describedin more detail below with respect to particular embodiments. Particularembodiments may repeat one or more steps of the method of FIG. 16, whereappropriate. Although this disclosure describes and illustratesparticular steps of the method of FIG. 16 as occurring in a particularorder, this disclosure contemplates any suitable steps of the method ofFIG. 16 occurring in any suitable order. Moreover, although thisdisclosure describes and illustrates an example method for monitoringthe stress level of the user, including the particular steps of themethod of FIG. 16, this disclosure contemplates any suitable method formonitoring any relevant physiological markers (e.g., PPG measurements,electrocardiography (EKG) measurements, blood pressure measurements,glucose readings, blood oxygen levels, temperature measurements, sleepduration measurement, sleep quality measurement, respiration parametermeasurement (e.g., related to rate, rhythm or volume), cardiac outputmeasurement, activity measurements, posture measurements, hydrationmeasurements, blood hemoglobin level measurements, blood lipid levelmeasurements, weight measurements, height measurement, fat measurement,gait measurement, posture measurement, skin conductance measurement,other suitable health/physiological measurements, or any combinationthereof) including any suitable steps, which may include all, some, ornone of the steps of the method of FIG. 16, where appropriate.Furthermore, although this disclosure describes and illustratesparticular components, devices, or systems carrying out particular stepsof the method of FIG. 16, this disclosure contemplates any suitablecombination of any suitable components, devices, or systems carrying outany suitable steps of the method of FIG. 16.

As discussed above, the method 1700 for continuous and power-efficientmonitoring of a user's stress level may be carried out via healthmonitoring system 200. The device may include a wearable electronicdevice (e.g., health monitoring device 210), a mobile device (e.g.,client system 120), a dedicated health monitoring device, any othersuitable monitoring device, or any combination thereof. As discussed indetail above, the device may include a processor, memory storing programinstructions and data, one or more sensors, and a display, where theprocessor may be configured to take biological measurements of the userusing the sensors, and the sensors may include PPG sensors, anaccelerometer, other suitable sensor, or any combination (e.g., fordetermining a heart rate of the user, for determining an activity levelof the user, etc.). In particular embodiments, the processor may processthe biological measurements and determine a stress level of the user. Asdescribed below, based on the processing of the biological measurements,the processor may provide a notification to the user to alert the userof certain stress events.

Alarm Fatigue Reduction

As discussed above, alarm fatigue is a key impediment for users. Forexample, alarm fatigue may occur when the user is alerted to everystress event that occurs throughout the day because many stress episodesare not harmful (e.g., small duration stress episodes, stress episodesthat are controlled by the person after a short homeostatic disturbance,etc.). Alarm fatigue may result in the situation where users are likelyto turn off bio-sensing when the reporting of the health status occursso frequently that the user starts to ignore any further warnings, whichmay be a serious issue with continuous bio-sensing and healthmonitoring. Particular embodiments described below are configured toreduce the number of events that trigger alerts to the user by focusingon physiological markers that are truly meaningful, as well as likelyactionable (e.g., the user may perform a stress-relieving activity toreduce or mitigate the level of stress). These physiological markers maybe used to determine the occurrence of debilitating, physiologicallyharmful levels of stress, such as chronic or prolonged stress.

By way of background, the limbic-hypothalamic-pituitary-adrenal (LHPA)axis is the central stress response system. When a stress event occurs,the LHPA axis is responsible for the stress response, and this responseis characterized by hypothalamic release of corticotropin-releasinghormone (CRF) such that when CRF binds to CRF receptors in the anteriorpituitary gland, adrenocorticotropic hormone (ACTH) is released. ACTHthen binds to receptors on the adrenal cortex and stimulates adrenalrelease of cortisol. Cortisol may be released in most people after 25 to30 minutes after the onset of the stress event. Cortisol then exertsnegative feedback to the hypothalamic release of CRF and the pituitaryrelease of ACTH, helping return the system back to stress homeostasis.However, prolonged and repeated release of cortisol may cause orexacerbate numerous health problems, such as heart disease, digestiveproblems, sleep problems, weight problems, autoimmune diseases, andpsychological problems (e.g., depression). Thus, particular embodimentsare directed to alerting the user of the occurrence of a stress eventand providing recommendations for how to reduce stress and return tohomeostasis. In addition, particular embodiments are further directed toproviding a stress alert after the onset of the stress event but priorto the release of cortisol such that the user may be able to engage instress-reducing activities that may mitigate and/or avoid the release ofcortisol.

FIG. 18 illustrates an example method 1800 for reducing alarm fatigueusing health monitoring system 200. The method begins at step 1810,where health monitoring system 200 may determine whether there is astress event. As shown in FIG. 18, when health monitoring system 200determines that there is no occurrence of a stress event (e.g., “NO” atstep 1810), then no notification is sent to the user and the methodterminates. On the other hand, when health monitoring system 200determines that there is an occurrence of a stress event (e.g., “YES” atstep 1810), then at step 1820, health monitoring system 200 may thendetermine whether the stress event lasts longer than a threshold amountof time. As shown in FIG. 18, when health monitoring system determinesthat the stress event does not last longer than the threshold amount oftime (e.g., “NO” at step 1820), then no notification is sent to the userand the method terminates. On the other hand, when health monitoringsystem 200 determines that the stress event does last longer than thethreshold amount of time (e.g., “YES” at step 1820), health monitoringsystem 200 then proceeds to step 1830. At step 1830, health monitoringsystem 200 may notify the user of the stress event. Then, the method mayterminate.

In particular embodiments, a stress event (e.g., severe stress) may bedefined as an event where a stress homeostasis level remainssignificantly disturbed (e.g., elevated from a baseline stress level fora particular context) for longer than a threshold period of time. As anexample and not by way of limitation, the threshold period of time maycorrespond to a time before a human body may release cortisol inresponse to the LHPA axis activation (e.g., longer than 15 to 20minutes, but less than 25-30 minutes). As discussed above, sincecortisol may be released in most people after 25 to 30 minutes, thisthreshold time period may reduce activation of LHPA axis by alerting theuser of a stress event that may cause the release of cortisol and/orallow the user to have an opportunity to reduce the stress level priorto, and in avoidance of, the release of cortisol. As another example andnot by way of limitation, significant homeostatic disturbance maycorrespond to a threshold variation in the stress level for apredetermined measurement period (e.g., more than 30% variation in thestress level maintained almost throughout the measurement period, suchas 95% of the measurement period).

In particular embodiments, health monitoring system 200 may determine anature, a level, or an intensity of physical activity of the user (e.g.,a context of an activity level) during the time period that the stresslevel is being measured. As an example and not by way of limitation, thesensors associated with health monitoring system 200, health monitoringdevice 210, client device 120, or any combination thereof (e.g., anaccelerometer, gyroscope, etc.) may be used to sense the nature, levelor intensity of the physical activity. This may be used to distinguishan increased heart rate (or other physiological marker) due to emotionalstate from an increased heart rate due to physical activity.

In particular embodiments, the notification to the user may comprise oneor more of user-interface notifications (e.g., message notifications,graphical notifications, etc.), haptic responses (e.g., vibrations,etc.), or audible signals (e.g., any type of noisy signal) by healthmonitoring system 200, health monitoring device 210, client device 120,another device paired to the health monitoring system 200, or anycombination thereof. In addition, based on user preference, thenotification may also be communicated to any number of third parties,including family members, friends, close contacts, care providers, othersuitable party, or any combination thereof.

Moreover, in particular embodiments, along with the notification, healthmonitoring system 200 may provide the user with asuggestion/recommendation for an approach to reducing the stress level,which may include activities that are a logical consequence that arisesfrom the stored sensor data detailing the context of an activity levelassociated with the user. As an example and not by way of limitation,this may include certain physical activities such as getting up andstretching, changing the posture, taking a small walk, hydratingoneself, a short acupressure-like massage, etc. As another example andnot by way of limitation, if the sensors detect that the user has beensedentary for a long time, then health monitoring system 200 mayrecommend to the user to get up and stretch or take a small walk toalleviate stress. As another example and not by way of limitation, ifthe sensors detect that the user is mobile but under high stress, thenhealth monitoring system 200 may recommend to the user to hydratehimself. As another example and not by way of limitation, if the sensorsdetect that the user is in certain meeting venues (e.g., a board room),or is unusually still while seated or standing, or when healthmonitoring system 200 detects that the stress level has spiked up veryhigh in a very short period of time, health monitoring system 200 mayrecommend a discrete acupressure stimulation of various stress points inthe body.

Although this disclosure describes and illustrates particular steps ofthe method of FIG. 18 as occurring in a particular order, thisdisclosure contemplates any suitable steps of the method of FIG. 18occurring in any suitable order. Moreover, although this disclosuredescribes and illustrates an example method for reducing alarm fatigueusing health monitoring system 200, including the particular steps ofthe method of FIG. 18, this disclosure contemplates any suitable methodand any relevant physiological markers (e.g., PPG measurements, EKGmeasurements, blood pressure measurements, glucose readings, bloodoxygen levels, temperature measurements, sleep duration measurement,sleep quality measurement, respiration parameter measurement (e.g.,related to rate, rhythm or volume), cardiac output measurement, activitymeasurements, posture measurements, hydration measurements, bloodhemoglobin level measurements, blood lipid level measurements, weightmeasurements, height measurement, fat measurement, gait measurement,posture measurement, skin conductance measurement, other suitablehealth/physiological measurements, or any combination thereof) forreducing alarm fatigue including any suitable steps, which may includeall, some, or none of the steps of the method of FIG. 18, whereappropriate. Furthermore, although this disclosure describes andillustrates particular components, devices, or systems carrying outparticular steps of the method of FIG. 18, this disclosure contemplatesany suitable combination of any suitable components, devices, or systemscarrying out any suitable steps of the method of FIG. 18.

Power Efficient Sampling

As discussed above, power efficient sampling and/or monitoring of thestress level is useful for both monitoring chronic and acute stress. Inparticular embodiments, for power-efficiency, health monitoring system200 may monitor chronic by detecting short term prolonged stress longerthan 15 minutes based on the notion that the release of cortisol (e.g.,LHPA axis activation, as discussed above) is the true short term sign ofharmful stress. As an example and not by way of limitation, the methodmay include an 8 second heart-rate sampling per minute, to compute theheart rate. This heart rate window may be used only when the user issedentary or engaging in light activity (e.g., so as to not confuse thedetection of stress with a high-activity level). When there is adetermination of heart rate elevation, then health monitoring system 200may sample alternate windows to detect the stress level. Based onexperimental results, this method my result in power consumption by thesensor to be about 8 to 10 time lower than continuous monitoring. Inaddition, for power efficiency, health monitoring system 200 may monitoracute stress by detecting acute episodes of stress that last for just afew minutes (e.g., without focusing on LHPA axis activation). As anexample and not by way of limitation, the method may include a 20 secondheart-rate sampling per minute, only when the user is sedentary orengaging in light activity. When there is a determination of heart rateelevation, then health monitoring system 200 may conduct 40-60 secondsof stress sampling every 60 sec seconds.

FIG. 19 illustrates an example method 1900 for power-efficientmonitoring using health monitoring system 200. The method may begin atstep 1910, where health monitoring system 200 starts in a first samplingmode. In particular embodiments, this step may include determining,based on biological measurements on one or more physiological markersreceiving in the first sampling mode, the stress level of the user. Atstep 1920, health monitoring system 200 may determine whether there is astress event. As shown in FIG. 19, when health monitoring system 200determines that there is no occurrence of a stress event (e.g., “NO” atstep 1920), then no notification is sent to the user and the methodterminates. On the other hand, when health monitoring system 200determines that there is an occurrence of a stress event (e.g., “YES” atstep 1920), then at step 1930, health monitoring system 200 may thendynamically switch to a second sampling mode. In particular embodiments,this step may include dynamically switching to the second sampling modewhen it is determined that one or more of the physiological markers areabove a threshold level, the second sampling mode being different fromthe first sampling mode. Then, at step 1940, health monitoring system200 may notify the user. After notifying the user, the method mayterminate.

In particular embodiment, health monitoring system 200 may receive, froma sensor of health monitoring system 200, the biological measurements onthe physiological markers. As an example and not by way of limitation,the sensors may be associated with health monitoring system 200, healthmonitoring device 210, client device 120, or any combination thereof,and may include sensors such as an accelerometer, gyroscope,activity-recognition sensors, UV sensors, humidity sensors, sleepsensors, hydration sensors, and bio-sensors such as ECG, PPG, EEG,electromyography (EMG), electrooculograpy (EOG), respiration sensors,other suitable sensors, or any combination thereof. The measurementscaptured by the sensor may include a nature, level, or intensity ofphysical activity. In addition, the physiological makers captured by thesensors may include PPG measurements, EKG measurements, blood pressuremeasurements, glucose readings, blood oxygen levels, temperaturemeasurements, sleep duration measurement, sleep quality measurement,respiration parameter measurement (e.g., related to rate, rhythm orvolume), cardiac output measurement, activity measurements, posturemeasurements, hydration measurements, blood hemoglobin levelmeasurements, blood lipid level measurements, weight measurements,height measurement, fat measurement, gait measurement, posturemeasurement, skin conductance measurement, other suitablehealth/physiological measurements, or any combination thereof.

In particular embodiments, the notification may be associated asdiscussed above, health monitoring system 200 may send the notificationto the user via health monitoring device 210, client device 120, othersuitable device, or any combination thereof. As discussed above, thenotification may comprise one or more of user-interface notifications(e.g., message notifications, graphical notifications, etc.), hapticresponses (e.g., vibrations, etc.), or audible signals (e.g., any typeof noisy signal) by health monitoring system 200, health monitoringdevice 210, client device 120, another device paired to the healthmonitoring system 200, or any combination thereof. In addition, based onuser preference, the notification may also be communicated to any numberof third parties, including family members, friends, close contacts,care providers, other suitable party, or any combination thereof.

In particular embodiments, the first sampling mode is a low-power modeand the second sampling mode is a high-power mode, and the low-powermode is associated with a first detection time period and the high-powermode is associated with a second detection time period. The seconddetection time period may correspond to a longer detection time periodfor a predetermined time period than the first detection time period(e.g., the first detection time period may correspond to a 20 secondheart rate sampling window every minute, while the second detection timeperiod may correspond to a 40 second heart rate sampling window everyminute). In addition, the second detection time period may correspond toa higher frequency of detection time periods with a predetermined timeperiod than the first detection time period (e.g., the first detectiontime period may correspond to a detection window of 5 seconds per 10seconds of every minute, while the second detection period maycorrespond to a detection window of 8 seconds per 10 seconds of everyminute).

In particular embodiments, health monitoring system 200 may determine acontext associated with user during the first sampling mode based on thebiological measurements, the context being defined by one or more of anature, a level, or an intensity of physical activity during the firstsampling mode. As an example and not by way of limitation, as discussedabove, the sensors associated with health monitoring system 200, healthmonitoring device 210, client device 120, or any combination thereof(e.g., an accelerometer, gyroscope, etc.) may be used to sense thenature, level or intensity of the physical activity. This may be used todistinguish an increased heart rate (or other physiological marker) dueto emotional state from an increased heart rate due to physicalactivity. In particular embodiments, as discussed in more detail below,health monitoring system 200 may dynamically switch back to the firstsampling mode when it is determined that the one or more physiologicalmarkers are not above the threshold level.

In particular embodiments, an episodic-sampling method may includereceiving the heartbeat, physical activity, and other physiologicalinformation from the sensors associated with health monitoring system200. As an example and not by way of limitation, heart rate informationis generated from the sensor for a single and continuous series ofapproximately 8 seconds every minute, and the physical activityinformation is received continuously. Then, health monitoring system 200may compute the average heart rate and the nature, level, and intensityof the activity of the user (e.g., using the accelerometer). If theheart rate is above a baseline heart rate (e.g., a user-specificbaseline heart rate) by a certain threshold (e.g., such as 10%), and isnot due to a physical activity that can describe such a hear rateelevation, then health monitoring system 200 may adjust the samplingwindow a single and continuous time series of 30 seconds every minute.

Then, health monitoring system 200 may initiate future sampling ofalternate 30-second time windows as long as the stress computed in thepreviously-sampled window is high (e.g., above a user-definedthreshold). If, on the other hand, health monitoring system 200determines that the previously-sampled window is no longer high (e.g.,above the user-defined threshold), health monitoring system 200 mayrevert back to computing heart rate for 8 seconds per every minute. Inaddition, as an alternative, instead of computing the stress level foronly every alternate window, health monitoring system 200 may compute anaverage stress value over a given period of time (e.g., an hour, anentire day, etc.) by adding the alternate windows.

In particular embodiments, the low-power mode may correspond to ameasurement of a first physiological marker, and the high-power mode maycorrespond to a measurement of a second physiological marker differentfrom the first physiological marker. As an example and no by way oflimitation, as discussed in more detail below, the low-power mode maycorrespond to a measurement of an average heart rate of the user (e.g.,which involves less intensive algorithms and is less computationallyexpensive), and the high-power mode may correspond to a measurement of aHRV of the user (e.g., which involves more intensive algorithms and ismore computationally expensive).

In particular embodiments, health monitoring system 200 may, prior todetermining the stress level of the user, receive a selection of one ormore stress-monitoring modes from the user, wherein thestress-monitoring modes comprises a chronic-stress-monitoring mode andan acute-stress-monitoring mode. In other words, the user may choosewhether health monitoring system 200 is to be operated in thechronic-stress-monitoring mode or the acute-stress-monitoring mode, orboth. As an example and not by way of limitation, when a user selectsboth the modes, this can be accomplished by setting a high threshold foracute stress monitoring mode to be triggered because an acute stressevent that requires immediate attention will be one where the stresslevel of the user is severely high (e.g., a stress level that approachesan extremely low HRV, such as to a value that is less than 10% of theestimated range in which the quantified stress values may change).

On the other hand, a chronic stress episode is defined as a stressepisode that lasts for a long period of time, and to capture such anepisode, health monitoring system 200 may continually sense the stressof the user so that a long period of high-level stress is determined.However, continuously sensing the user's stress level may be very energyconsuming with respect to the power consumed by the sensors beingdeployed for the stress monitoring. In particular embodiments, forbetter power efficiency, health monitoring system 200 may not keep thesensors ON for the full period of time during which health monitoringsystem 200 is engaged in monitoring the user's stress. Instead, inparticular embodiments, a method for determining chronic/prolonged oracute stress may include health monitoring system 200 first receiving auser preference for being monitored for chronic stress, or acute stress,or both. Health monitoring system 200 may then detect the physiologicalmarkers (e.g., the user's heart rate) based on the above-describedepisodic-sampling method.

In particular embodiments, health monitoring system 200 may determinethat the detected stress level is acutely high if the computed stresslevel is above a threshold (e.g., 40% or more sustained elevation of thecomputed stress level) and meets other criterion (e.g., total stresslevel elevation time of 5 minutes or more) that are associated withidentifying an acute stress level. Then, health monitoring system 200may provide a notification and feedback/recommendations to the userbased on the acute stress level (e.g., if such a preference was selectedby the user).

On the other hand, in particular embodiments, health monitoring system200 may determine that the detected stress level is chronicallyhigh/prolonged if the computed stress is above a threshold (e.g., 40% ormore sustained elevation of the computed stress) and meets othercriterion (e.g., total stress elevation time of 25 minutes or more) thatare associated with identifying a chronic stress level. Then, healthmonitoring system 200 may provide a notification andfeedback/recommendations to the user based on the chronic stress level(e.g., if such a preference was selected by the user).

In addition, if health monitoring system 200 is set to provide a warningfor impending LHPA axis activation that may overwhelm the stresshomeostasis, then health monitoring system 200 may provide such anotification after that period (e.g., around 15 minutes after theinitial high stress and/or stress event was detected).

In particular embodiments, in the presence of sustained accelerometeractivity, the health monitoring system 200 may provide a (e.g., default)option to turn off the concurrent heart rate sensing. This may provideadditional gains in power efficiency.

In particular embodiments, the method may include hierarchicaldecision-making capabilities. As an example and not by way oflimitation, health monitoring system 200 may use a low energy sensor totest the elevation in stress level (e.g., by using a galvanic skinresponse (GSR)-like sensor) before beginning the more expensivemonitoring based on PPG signals. Similarly, health monitoring system 200may use one or more sophisticated filers before invoking a moreexpensive sensing modality. As an example and not by way of limitation,health monitoring system 200 that may sense for the user's stress levelevery alternate period of 30 seconds may be replaced by one that sensesperiods of 45 seconds with an interim gap that is smaller in length(e.g., 15 seconds), or an interim gap that is longer in length (e.g., 45seconds). In general, sampling decisions may be determined based on thesensed stress level and the user preference where health monitoringsystem 200 may optimize energy consumed as well as meeting themonitoring requirements of the user.

Although this disclosure describes and illustrates particular steps ofthe method of FIG. 19 as occurring in a particular order, thisdisclosure contemplates any suitable steps of the method of FIG. 19occurring in any suitable order. Moreover, although this disclosuredescribes and illustrates an example method for power-efficientmonitoring using health monitoring system 200, including the particularsteps of the method of FIG. 19, this disclosure contemplates anysuitable method and any relevant physiological markers (e.g., PPGmeasurements, EKG measurements, blood pressure measurements, glucosereadings, blood oxygen levels, temperature measurements, sleep durationmeasurement, sleep quality measurement, respiration parametermeasurement (e.g., related to rate, rhythm or volume), cardiac outputmeasurement, activity measurements, posture measurements, hydrationmeasurements, blood hemoglobin level measurements, blood lipid levelmeasurements, weight measurements, height measurement, fat measurement,gait measurement, posture measurement, skin conductance measurement,other suitable health/physiological measurements, or any combinationthereof) for power-efficient monitoring including any suitable steps,which may include all, some, or none of the steps of the method of FIG.19, where appropriate. Furthermore, although this disclosure describesand illustrates particular components, devices, or systems carrying outparticular steps of the method of FIG. 19, this disclosure contemplatesany suitable combination of any suitable components, devices, or systemscarrying out any suitable steps of the method of FIG. 19.

User Baseline Contexts and Stress Coping Capacity

As discussed above, in mobile health monitoring and management, use ofwearable devices is considered to be key for creating novel methods andsystems in health management. Health measurements may be a bridge tomanagement of a wide variety of health problems, such as diabetes,stress, hypertension, cardiovascular diseases, pulmonary diseases, mooddisorder, substance-abuse, general quality of life, etc. A contextualbaselining approach may be applied to a set of user-specificphysiological measurements to make those measurements sensible, therebyproviding real feedback about what the user is doing to improve or hurtthe user's health, and how the user's body is reacting to differentsituations. Similarly, stress monitoring and management should also becontext aware (e.g., analyzing stress measurements relative to thecontext of the stress measurement). Accordingly, non-invasive stressmeasurements combined with contextual awareness may provide a powerfultool for dealing with stress and/or other physiological measurements,recognizing harmful stress levels, diagnosing stress as a cause for asymptom, etc.

Example Embodiments of Context Engine Associated with Health MonitoringEngine

FIG. 20 illustrates example software and hardware components of healthmonitoring system 200. In particular embodiments, health monitoringsystem 200 may include a context engine 2010, a health monitor engine2020, one or more context sensors 2030, one or more biosensors 2040, anda memory system 2050. Health monitoring system 200 may be deployed on anumber of types of devices, such as a wearable device (e.g., healthmonitoring device 210), a mobile device (e.g., client system 120), apersonal computer (e.g., client system 120), a dedicated medicalmonitoring device, a smart TV, other suitable device, and anycombination thereof. As discussed in more detail below, healthmonitoring system 200 may be configured to detect, monitor, and analyzea number of health measurements 2042 (e.g., physiological measurements)of a user and determine a health characteristic of the user as anoutput. As an example and not by way of limitation, health measurements2042 may include PPG measurements, EKG measurements, blood pressuremeasurements, glucose readings, blood oxygen levels, temperaturemeasurements, sleep duration measurement, sleep quality measurement,respiration parameter measurement (e.g., related to rate, rhythm orvolume), cardiac output measurement, activity measurements, posturemeasurements, hydration measurements, blood hemoglobin levelmeasurements, blood lipid level measurements, weight measurements,height measurement, fat measurement, gait measurement, posturemeasurement, skin conductance measurement, other suitablehealth/physiological measurements, or any combination thereof.

In addition, as an example and not by way of limitation, a healthcharacteristic may include stress, heart rate, blood pressure, glucoselevel, arrhythmia, respiratory parameters such as rate, rhythm andvolume, peripheral and/or core temperature, hydration level, galvanicskin response, EEG characteristics, EMG characteristics, gait, posture,activity, sleep, cardiac output, weight, body mass index (BMI), bonemineral density (BMD), other relevant health characteristic, or anycombination thereof. In particular embodiments, the healthcharacteristic may be determined relative to one or more contexts. As anexample and not by way of limitation, the contexts may include at theoffice vs. at home, awake vs. asleep, weekdays vs. weekends, day vs.night, morning vs. evening, before sleep vs. after sleep, indoor vs.outdoors, leisure activity vs. predetermined daily chores, beforeexercise vs. after exercise, alone vs. with company, healthy vs. sick,poor posture vs. correct posture, calm vs. fidgety, quiet vs. vocal,hydrated vs. dehydrated, hypertensive vs. normotensive, hungry vs.well-fed, low oxygen saturation vs. normal oxygen saturation, otherrelevant contexts, or any combination thereof. In particularembodiments, the context may be associated with a baseline (e.g., auser-specific baseline) of the health characteristic, which a currenthealth characteristic may be measured against. In particularembodiments, health monitoring system 200 may determine the context inan automatic, semi-automatic, or manual method. Moreover, healthmonitoring system 200 may update the baseline of each context in anautomatic, semi-automatic, or manual manner.

In particular embodiments, context engine 2010 may be configured toreceive one or more context measurements 2032 and determine a context.As an example and not by way of limitation, contexts may be defined byspace-time coordinates and may be determined or selected based by usinga calendar, a time-clock, GPS, in-plane switching (IPS), ultraviolet(UV) sensors, humidity sensors, barometer, other suitable contextdefinitions/selections, or any combination thereof. Context measurements2032 may be provided by context sensors 2030. As an example and not byway of limitation, context measurements 2032 may include GPSmeasurements, accelerometer measurements, calendar measurements, timemeasurements, in—IPS measurements, temperature measurements, soundmeasurements, posture measurements, activity measurements, UV lightmeasurements, sound measurements, barometer measurements, other suitablemeasurements, or any combination thereof. In addition, context sensors2030 may include UV sensors, humidity sensors, a barometer, GPS, IPS,the calendar, other suitable sensors, or any combination thereof. Thecontext may be selected from a database of context records stored bymemory system 2050. In addition, health monitor engine 2020 may beconfigured to receive the context output from the context engine andalso receive health measurements 2042 from biosensors 2040.

In particular embodiments, memory system 2050 stores a plurality ofcontext records 2060, which is available via context engine 2010. Eachof context records 2060 may be representative of a context of the usersuch that the collection of contexts represents each possible context(e.g., user-specific context) that health monitoring system 200 maydistinguish. As shown in FIG. 20, context records 2060 include a numberof data entries (e.g., data fields) that are representative of a contextID 2062, a context signature 2064, a baseline value 2066, storedmeasurement data 2068, and a persistency factor 2070. Context ID 2062may be a unique identifier and/or name for a context record of contextrecords 2060. As an example and not by way of limitation, context ID2062 may correspond to “work week,” “weekend,” “commute,” “exercise,”“playing a video game,” other suitable context identifiers, or anycombination thereof. Context signature 2064 may be a set of values thatcontext measurement 2032 are compared to. As an example and not by wayof limitation, context engine 2010 may select a particular contextrecord of the plurality of context records 2060 in response todetermining that context measurements 2062 match context signature 2064of the particular context record.

Baseline 2066 may represent the baseline values of the healthcharacteristics of the user for the corresponding context. Storedmeasurement data 2068 may include stored context measurements (e.g.,previously collected by context sensors 2030) and/or health measurements(e.g., previously collected by biosensors 2040). Stored measurement data2068 may be used to update context signature 2064 and/or to identify newcontexts based on patterns of user behavior or activities. As an exampleand not by way of limitation, health monitoring system 200 may trackcontext measurements 2032 of the user and analyze them for patterns. Inresponse to matching a pattern, health monitoring system 200 may promptthe user to confirm that a corresponding new context has occurred and/orwhether the user would like to “activate” the new context for futuremonitoring. Persistency factor 2070 may be data that represents how longthe effects of a particular context may be taken into account. As anexample and not by way of limitation, a stressful commute may affect thecontext of the user for up to 4 hours after the commute has finished.

FIG. 21 illustrates an example method 2100 for generating and/orupdating context records of a user. The method may begin at step 2110,where health monitoring system 200 may receive a health measurement(e.g., health measurements 2042 via biosensors 2040). In particularembodiments, in response to receiving the health measurement, healthmonitoring system 200 may request context engine 2010 to determine thecurrent context. As such, at step 2120, health monitoring system 200 mayreceive a context measurement (e.g., context measurements 2032 viacontext sensor 2030). In particular embodiments, health monitoringsystem 200, via context engine 2010, may compare the received contextmeasurements to the context signature data fields (e.g., contextsignature 2064) of context records 2060 stored for the user by memorysystem 2050. Then, at step 2130, health monitoring system 200 may selecta context record from a plurality of stored context records (e.g., fromcontext record 2060 stored in memory system 2050) having a contextsignature matching the context measurements.

In particular embodiments, the context may include information on agiven location, activity, weather, and other relevant space-timeinformation. As an example and not by way of limitation, with respect tothe activity information, using just accelerometers and gyroscopes,health monitoring system 200 may identify certain activities, such aswalking, running, biking, exercising, other similar activities, and anyapplicable combination thereof. As another example and not by way oflimitation, using additional sensors such as UV sensors, humiditysensors, sleep sensors, hydration sensors, and bio-sensors such as ECG,PPG, EEG, EMG, EOG, respiration sensors, etc., an activity may bedefined by a method which first attempts to define an event with respectto any label that one of the sensors can impose upon the user's activity(e.g., Context A), which may be either provided to the system by theuser or determined by the value of the sensors (e.g., Content S). As anexample and not by way of limitation, Context A may include contextssuch as the user being in a boardroom, after a particular time on aweekday morning, when the user is at a hospital or at an old age nursinghome, after doing some chores at home (e.g., which can be detected by anactivity-recognition sensor), the user being sedentary at his desk withpoor posture for more than 1 hour, the user sleeping later than acertain time, the user getting after a certain time, other suitablecontexts, or any combination thereof. These contexts may have a specificconnotation or meaning for the user and hence he cares about monitoringhis stress in such contexts.

In particular embodiments, the context may be automatically detected byhealth monitoring system 200. Automatically-detected contexts may bepre-populated into memory system 2050 of health monitoring system 200 ordynamically determined after learning the user's characteristichealth/stress profile. As an example and not by way of limitation,Context S may include a user's weekend or weekday (regular) commute, theuser being at work, the user being at a park during a weekend, the userbeing in a noisy environment, the user being at a high elevation, lowoxygen saturation, the user being outside a high ultraviolet lightindex, the user waking up with a restless or short sleep, the user beingdehydrated, the user being sedentary at work for a very long time, theuser just completing intense physical exertion or sitting front of histelevision in his living room for a long period of time, the user havinga very angry outburst (e.g., as detected by voice analysis from themobile device sensors), other automatically detectable contexts, and anyapplicable combination thereof. In particular embodiments, contexts maybe generated by concurrent analysis of multiple sensors at the sametime.

At step 2140, health monitoring system 200 may determine whether toupdate the selected context record. If the determination at step 2140 isYES, then the method moves on to step 2150, where health monitoringsystem 200 may update the selected context record based on at least oneof the received health measurement or the received context measurement.In particular embodiments, the determination of whether the contextrecord is to be updated may be based on a number of factors (e.g., thenumber of unprocessed stored health measurements of the context record,an amount of time since the last update to the context record, etc.). Asan example and not by way of limitation, each context may be associatedwith what are the normal values for other contexts, and the baselinedata for the given context may only be updated if these other contextvalues remain within a normal/predetermined range. In particularembodiments, in response to a determination that the context record isto be updated, context engine 2010 of health monitoring system 200 mayupdate the baseline value of the selected context record. As an exampleand not by way of limitation, the baseline value for a context may begenerated by taking an average of a set of readings on that context(e.g., where the set may be either defined by the user or be the set ofall readings for that given context). As another example and not by wayof limitation, the baseline may be generated based on a weighted averagewith a decaying window or moving window so that old measurements arediscarded over time. In particular embodiments, context engine 2010 ofhealth monitoring system 200 may automatically update the baseline valueof the selected context record. After the selected context record isupdated, the method may terminate.

On the other hand, if the determination at step 2140 is NO, then themethod moves on to step 2160, where health monitoring system 200 maystore at least one of the health measurement or the context measurementin the selected context record. In particular embodiments, in responseto a determination that the context record is not to be updated, contextengine 2010 of health monitoring system 200 may store the receivedhealth measurements in the stored measurement data field (e.g., viastored measurement data 2068) of the selected context record. The storedhealth measurements may then be accessed and/or processed at a latertime. Then, the method may terminate.

In particular embodiments, for stress monitoring, users may each have adifferent baseline stress level (e.g., based on HRV), and thus thestress-level determination must consider the baseline of each individualuser. However, the baseline stress level itself is different based onthe context (e.g., at the office vs. at home, awake vs. asleep, weekdaysvs. weekends, etc.) and/or activity (e.g., before, during or aftersleep, meals, exercise, consuming media content, doing household chores,etc.). The methods described above may be configured to automaticallycreate correct baselines for different contexts based on collectedcontext measurements 2032 and health measurements 2042. As such, thecontext may be defined not just using space-time co-ordinates but alsoin terms of the context (e.g., repeated biological states) and/oractivity performed (e.g., repeated user activity).

Particular embodiments may repeat one or more steps of the method ofFIG. 21, where appropriate. Although this disclosure describes andillustrates particular steps of the method of FIG. 21 as occurring in aparticular order, this disclosure contemplates any suitable steps of themethod of FIG. 21 occurring in any suitable order. Moreover, althoughthis disclosure describes and illustrates an example method forgenerating and/or updating context records of a user including theparticular steps of the method of FIG. 21, this disclosure contemplatesany suitable method for generating and/or updating context records of auser including any suitable steps, which may include all, some, or noneof the steps of the method of FIG. 21, where appropriate. Furthermore,although this disclosure describes and illustrates particularcomponents, devices, or systems carrying out particular steps of themethod of FIG. 21, this disclosure contemplates any suitable combinationof any suitable components, devices, or systems carrying out anysuitable steps of the method of FIG. 21.

Performing Health Monitoring Based on Contexts

FIG. 22 illustrates an example method 2200 for generating a healthcharacteristic output for the user. The method may begin at step 2210,where health monitoring system 200 may receive a health measurement(e.g., health measurements 2042 via biosensors 2040). In response,health monitoring system 200 may request context engine 2010 todetermine the current context in order to evaluate the healthmeasurement. At step 2220, health monitoring system 200 may receive acontext measurement (e.g., context measurements 2032 via context sensor2030). At step 2230, health monitoring system 200 may select a contextrecord from a plurality of stored context records (e.g., from contextrecord 2060 stored in memory system 2050). In particular embodiments,context engine 2010 may then select a context record of the plurality ofcontext records 2060 stored by memory system 2050 by comparing thereceived context measurements to the context signature data fields ofthe context records (e.g., via context signature 2064) stored by memorysystem 2050. Context engine 2010 selects the context record of therecord having a context signature matching or substantially similar tothe received context measurements. The selected context record includesthe baseline value (e.g., via baseline 2066) of the determined context.As an example and not by way of limitation, the baseline value may be auser-specific baseline value for a particular context. Then, at step2240, health monitoring system 200 may determine a health characteristicrelative to a baseline value of the selected context record. As such,health monitoring system 200 may compute the health characteristic basedon the received health measurement and in comparison with the baselinevalue of the selected context.

In particular embodiments, health monitoring system 200 may monitor oneor more health characteristics of the user (e.g., stress level, heartrate, HRV, etc.) and provide the user an output that is representativeof the health characteristic. Additionally or alternatively, the healthcharacteristic can be stored for later retrieval, such as by a doctorfor diagnostic purposes.

In particular embodiments, health monitoring system 200 may facilitateuser-in-the-loop operation to select the context. As an example and notby way of limitation, health monitoring system 200 may operate in afully manual way so that the user may supply user input to define anumber of contexts and/or indicate the current context. Additionally oralternatively, health monitoring system 200 may provide the user with alist of prepopulated contexts to choose from. Over time, healthmonitoring system 200 may update the baseline values when the userselects the context. Alternatively, in particular embodiments, healthmonitoring system 200 may operate in a semi-automatic way, whereinhealth monitoring system 200 may provide the user with prompts toconfirm automatic detection of context or to request that the userselect the context in the event that the system cannot determine thecontext. In addition, in particular embodiments, health monitoringsystem 200 may automatically select the context based on the receivedcontext measurements.

Particular embodiments may repeat one or more steps of the method ofFIG. 22, where appropriate. Although this disclosure describes andillustrates particular steps of the method of FIG. 22 as occurring in aparticular order, this disclosure contemplates any suitable steps of themethod of FIG. 22 occurring in any suitable order. Moreover, althoughthis disclosure describes and illustrates an example method forgenerating a health characteristic output for the user including theparticular steps of the method of FIG. 22, this disclosure contemplatesany suitable method for generating a health characteristic output forthe user including any suitable steps, which may include all, some, ornone of the steps of the method of FIG. 22, where appropriate.Furthermore, although this disclosure describes and illustratesparticular components, devices, or systems carrying out particular stepsof the method of FIG. 22, this disclosure contemplates any suitablecombination of any suitable components, devices, or systems carrying outany suitable steps of the method of FIG. 22.

Determining Emotional Health and Resiliency

A number of existing stress monitoring tools only provide various formsof raw stress values, which does not provide a useful measure for healthmaintenance, that is, the resiliency of the user. As an example, healthmonitoring system 200 may compute the time a user spends in a given HRVzone (e.g., showing high stress or high relaxation). As this timeincreases or decreases, the user gets a resiliency factor on whether hisstress coping skills or relaxation maintenance capacity has shown anyimprovements. Health monitoring system 200 may compute various suchmeasurements as a useful measure of the user's stress coping skills, orbenefit from any wellness program he may be undertaking in overcomingstress or maintaining a state of relaxation.

In particular embodiments, health monitoring system 200 may utilize theresiliency factor (e.g., a health resiliency measurement) of the contextrecord to determine the lasting effects of events. As an example and notby way of limitation, the effects of a stressful drive or the effects ofa stressful workday, or the calm provided by reading a book may be takeninto account. In particular embodiments, the resiliency factor cancorrespond to a period of time for analyzing the baseline value of thecontext after the context is over based on a determination that overtime, the effect of a previous context may decrease abruptly orgradually. In particular embodiments, the baseline value may be acombination of the baselines of the active contexts (e.g., including theprevious context within the resiliency period and the current context).As an example and not by way of limitation, the combination of thebaselines may be determined based on the maximum, the minimum, theaverage, or a convex combination of the baselines.

FIG. 23 illustrates an example method 2300 for determining a user'semotional health based on a health-resiliency measurement. The methodmay begin at step 2310, where health monitoring system 200 may detect afirst event corresponding to a health characteristic of a user being afirst level. At step 2320, health monitoring system 200 may detect asecond event corresponding to the health characteristic of the userbeing at a second level. At step 2330, health monitoring system 200 maydetermine the elapsed time between the first and second events as anindication of emotional health, wherein the elapsed time between thefirst and second events may correspond to a health-resiliencymeasurement associated with the user.

In particular embodiments, stress resilience for any user for a givencontext may be measured by determining a time T taken by the user tomake a transition from a first range of stress values (e.g., defined asone of a set of labels of possible stress values or as a numeric value)to a second range of stress values, within the later range may bedefined as a baseline state for the particular context. Alternatively,in particular embodiments, stress resilience may be defined as D/T,where D is the difference between the original stress value and thefinal stress value, and T is the time taken to make this transition.Moreover, a “relaxation” resilience may be defined using a similarapproach. As an example and not by way of limitation, when multipleinstances of a health-resiliency measurement corresponding to stress hasalready been computed in which the health resilience corresponds to anaverage time to recover back to a pre-defined stress zone (e.g., an HRVzone between 40-60), the stress resilience for a context C may bedetermined based on

${{SR} = {\frac{1}{n}{\sum_{k = 0}^{n}t_{i}}}},$

where context C includes n events (e.g., {e₁, . . . , e_(n)}), and therecovery time is {t₁, . . . , t_(n)}. In particular embodiments, suchinformation may be provided to the user using charts that show the HRVrecovery time along with the context & actual value of HRV.

In particular embodiments, as discussed above, the health-resiliencymeasurement may be improved by including types of events/contexts tohelp interpret the health-resiliency measurement. As such, an extensionof the previously-described resilience computations may include afunctionality of “contextual resilience.” In particular embodiments,contextual resilience may be a marker of allostatic load being imposedby events and contexts, and such information may be helpful to the userbecause it provides a functionality for determining which situationsreduce emotional health, and what changes in the lifestyle may led tobetter resilience and better emotional coping capacity. As an exampleand not by way of definition, if during weekdays the user's stressresilience is very low, then health monitoring system 200 may giveprovide feedback to the user that he has a lower emotional health duringthis period. In contrast, if the user is in a post-exercise period, thenhealth monitoring system 200 may give provide feedback to the user thathe has high emotional health and high stress resilience during thisperiod.

In particular embodiments, the quantification scale associated withresiliency allows for consistent stages of severe stress, high stress,moderate stress, etc. In a panic attack or severe stress episodes, therecovery time may be defined in stages and hence the resiliencymeasurement is more useful than a stress level at any particular state.As an example and not by way of limitation, in the instance of a panicattack or severe stress episode, a user's stress health may be providedby health monitoring system 200 as a tuple such as (resilience_escape,resilience_normal) where resilience-escape corresponds to a timerequired for the user to completely come out of a severe stress zone(hold time), and resilience_normal corresponds to a time required tocompletely come back to a normal zone (recovery time). The hold time mayalternatively be defined as starting from any specific point in thestress zone. Thus, this quantification scale associated with resiliencymay allow variety of stress scenarios to be accommodated. Moreover,these stress management functionalities, in addition to those describedabove, may be used to determine and quantify how well the stressreduction techniques are working for the user.

In particular embodiments, with regard to notifications to the userassociated with resiliency, when health monitoring system 200 determinesthat the baseline of the user has shifted upwards after a period of use,or if his stress baseline is otherwise significantly affected, then hecan be provided stress reduction options as consistent with thissituations and his preferences. Similarly, when health monitoring system200 determines that the user's stress resilience has worsened, healthmonitoring system 200 may provide the user with assistance and/orrecommendations that are commensurate with this new health status. Thesesuggestions may be provided to the user automatically or be chosen bythe user from a menu of options that changes based on the health statusof the user. In particular embodiments, the above-described resiliencynot limited to stress, and may be used to quantify other measurementssuch as mental states, arousal (e.g., sadness, irritation, etc.), othersuitable measurements, and any combination thereof.

As discussed above, the contexts can be computed based upon space andtime coordinates as well as activities or the pattern of the activities.In particular embodiments, the notifications to the user may be tailoredbased on the type of measurements that are made about the context, thebaseline value, and the corresponding resiliency measurement (e.g.,providing recommendations that are based on an awareness of the need ofthe context as well as what has been known to be effective for theuser). As an example and not by way of limitation, if the stressdetected is high in the context of a boardroom meeting and the baselinevalue of such measurements has been continually increasing and/or theresilience continually worsening, then a notification of stressreduction may be sent to the user which is consistent with theconstraints imposed by the user's setting.

In particular embodiments, improvements in resilience may be used toquantify or assess the benefits of a particular stress managementservice. As such, the contextual baseline values andresiliency-measurement determinations may provide a logical metricaround which diagnosis and services can be built.

Particular embodiments may repeat one or more steps of the method ofFIG. 23, where appropriate. Although this disclosure describes andillustrates particular steps of the method of FIG. 23 as occurring in aparticular order, this disclosure contemplates any suitable steps of themethod of FIG. 23 occurring in any suitable order. Moreover, althoughthis disclosure describes and illustrates an example method fordetermining a user's emotional health based on a health-resiliencymeasurement including the particular steps of the method of FIG. 23,this disclosure contemplates any suitable method for determining auser's emotional health based on a health-resiliency measurementincluding any suitable steps, which may include all, some, or none ofthe steps of the method of FIG. 23, where appropriate. Furthermore,although this disclosure describes and illustrates particularcomponents, devices, or systems carrying out particular steps of themethod of FIG. 23, this disclosure contemplates any suitable combinationof any suitable components, devices, or systems carrying out anysuitable steps of the method of FIG. 23.

Systems and Methods

FIG. 24 illustrates an example computer system 2400 according to someembodiments of the invention. In particular embodiments, one or morecomputer systems 2400 perform one or more steps of one or more methodsdescribed or illustrated herein. In particular embodiments, one or morecomputer systems 2400 provide functionality described or illustratedherein. In particular embodiments, software running on one or morecomputer systems 2400 performs one or more steps of one or more methodsdescribed or illustrated herein or provides functionality described orillustrated herein. Particular embodiments include one or more portionsof one or more computer systems 2400. Herein, reference to a computersystem may encompass a computing device, and vice versa, whereappropriate. Moreover, reference to a computer system may encompass oneor more computer systems, where appropriate.

This disclosure contemplates any suitable number of computer systems2400. This disclosure contemplates computer system 2400 taking anysuitable physical form. As example and not by way of limitation,computer system 2400 may be an embedded computer system, asystem-on-chip (SOC), a single-board computer system (SBC) (such as, forexample, a computer-on-module (COM) or system-on-module (SOM)), adesktop computer system, a laptop or notebook computer system, aninteractive kiosk, a mainframe, a mesh of computer systems, a mobiletelephone, a personal digital assistant (PDA), a server, a tabletcomputer system, or a combination of two or more of these. Whereappropriate, computer system 2400 may include one or more computersystems 2400; be unitary or distributed; span multiple locations; spanmultiple machines; span multiple data centers; or reside in a cloud,which may include one or more cloud components in one or more networks.Where appropriate, one or more computer systems 2400 may perform withoutsubstantial spatial or temporal limitation one or more steps of one ormore methods described or illustrated herein. As an example and not byway of limitation, one or more computer systems 2400 may perform in realtime or in batch mode one or more steps of one or more methods describedor illustrated herein. One or more computer systems 2400 may perform atdifferent times or at different locations one or more steps of one ormore methods described or illustrated herein, where appropriate.

In particular embodiments, computer system 2400 includes a processor2402, memory 2404, storage 2406, an input/output (I/O) interface 2408, acommunication interface 2410, and a bus 2412. Although this disclosuredescribes and illustrates a particular computer system having aparticular number of particular components in a particular arrangement,this disclosure contemplates any suitable computer system having anysuitable number of any suitable components in any suitable arrangement.

In particular embodiments, processor 2402 includes hardware forexecuting instructions, such as those making up a computer program. Inparticular embodiments, the computer program causes the processor 2402to perform one or more steps of one or more methods described orillustrated herein or provides functionality described or illustratedherein. In this way, the processor 2402 coupled to the computer programis a special purpose processor for performing the functions defined bythe computer program. As an example and not by way of limitation, toexecute instructions, processor 2402 may retrieve (or fetch) theinstructions from an internal register, an internal cache, memory 2404,or storage 2406; decode and execute them; and then write one or moreresults to an internal register, an internal cache, memory 2404, orstorage 2406. In particular embodiments, processor 2402 may include oneor more internal caches for data, instructions, or addresses. Thisdisclosure contemplates processor 2402 including any suitable number ofany suitable internal caches, where appropriate. As an example and notby way of limitation, processor 2402 may include one or more instructioncaches, one or more data caches, and one or more translation lookasidebuffers (TLBs). Instructions in the instruction caches may be copies ofinstructions in memory 2404 or storage 2406, and the instruction cachesmay speed up retrieval of those instructions by processor 2402. Data inthe data caches may be copies of data in memory 2404 or storage 2406 forinstructions executing at processor 2402 to operate on; the results ofprevious instructions executed at processor 2402 for access bysubsequent instructions executing at processor 2402 or for writing tomemory 2404 or storage 2406; or other suitable data. The data caches mayspeed up read or write operations by processor 2402. The TLBs may speedup virtual-address translation for processor 2402. In particularembodiments, processor 2402 may include one or more internal registersfor data, instructions, or addresses. This disclosure contemplatesprocessor 2402 including any suitable number of any suitable internalregisters, where appropriate. Where appropriate, processor 2402 mayinclude one or more arithmetic logic units (ALUs); be a multi-coreprocessor; or include one or more processors 2402. Although thisdisclosure describes and illustrates a particular processor, thisdisclosure contemplates any suitable processor.

In particular embodiments, memory 2404 includes main memory for storinginstructions for processor 2402 to execute or data for processor 2402 tooperate on. As an example and not by way of limitation, computer system2400 may load instructions from storage 2406 or another source (such as,for example, another computer system 2400) to memory 2404. Processor2402 may then load the instructions from memory 2404 to an internalregister or internal cache. To execute the instructions, processor 2402may retrieve the instructions from the internal register or internalcache and decode them. During or after execution of the instructions,processor 2402 may write one or more results (which may be intermediateor final results) to the internal register or internal cache. Processor2402 may then write one or more of those results to memory 2404. Inparticular embodiments, processor 2402 executes only instructions in oneor more internal registers or internal caches or in memory 2404 (asopposed to storage 2406 or elsewhere) and operates only on data in oneor more internal registers or internal caches or in memory 2404 (asopposed to storage 2406 or elsewhere). One or more memory buses (whichmay each include an address bus and a data bus) may couple processor2402 to memory 2404. Bus 2412 may include one or more memory buses, asdescribed below. In particular embodiments, one or more memorymanagement units (MMUs) reside between processor 2402 and memory 2404and facilitate accesses to memory 2404 requested by processor 2402. Inparticular embodiments, memory 2404 includes random access memory (RAM).This RAM may be volatile memory, or may be dynamic RAM (DRAM) or staticRAM (SRAM). Moreover, where appropriate, this RAM may be single-portedor multi-ported RAM. This disclosure contemplates any suitable RAM.Memory 2404 may include one or more memories 2404, where appropriate.Although this disclosure describes and illustrates particular memory,this disclosure contemplates any suitable memory.

In particular embodiments, storage 2406 includes mass storage for dataor instructions. As an example and not by way of limitation, storage2406 may include a hard disk drive (HDD), a floppy disk drive, flashmemory, an optical disc, a magneto-optical disc, magnetic tape, or aUniversal Serial Bus (USB) drive or a combination of two or more ofthese. Storage 2406 may include removable or non-removable (or fixed)media, where appropriate. Storage 2406 may be internal or external tocomputer system 2400, where appropriate. In particular embodiments,storage 2406 is non-volatile, solid-state memory. In particularembodiments, storage 2406 includes read-only memory (ROM). Whereappropriate, this ROM may be mask-programmed ROM, programmable ROM(PROM), erasable PROM (EPROM), electrically erasable PROM (EEPROM),electrically alterable ROM (EAROM), or flash memory or a combination oftwo or more of these. This disclosure contemplates mass storage 2406taking any suitable physical form. Storage 2406 may include one or morestorage control units facilitating communication between processor 2402and storage 2406, where appropriate. Where appropriate, storage 2406 mayinclude one or more storages 2406. Although this disclosure describesand illustrates particular storage, this disclosure contemplates anysuitable storage.

In particular embodiments, I/O interface 2408 includes hardware,software, or both, providing one or more interfaces for communicationbetween computer system 2400 and one or more I/O devices. Computersystem 2400 may include one or more of these I/O devices, whereappropriate. One or more of these I/O devices may enable communicationbetween a person and computer system 2400. As an example and not by wayof limitation, an I/O device may include a keyboard, keypad, microphone,monitor, mouse, printer, scanner, speaker, still camera, stylus, tablet,touch screen, trackball, video camera, another suitable I/O device or acombination of two or more of these. An I/O device may include one ormore sensors. This disclosure contemplates any suitable I/O devices andany suitable I/O interfaces 2408 for them. Where appropriate, I/Ointerface 2408 may include one or more device or software driversenabling processor 2402 to drive one or more of these I/O devices. I/Ointerface 2408 may include one or more I/O interfaces 2408, whereappropriate. Although this disclosure describes and illustrates aparticular I/O interface, this disclosure contemplates any suitable I/Ointerface.

In particular embodiments, communication interface 2410 includeshardware, software, or both providing one or more interfaces forcommunication (such as, for example, packet-based communication) betweencomputer system 2400 and one or more other computer systems 2400 or oneor more networks. As an example and not by way of limitation,communication interface 2410 may include a network interface controller(NIC) or network adapter for communicating with an Ethernet or otherwire-based network or a wireless NIC (WNIC) or wireless adapter forcommunicating with a wireless network, such as a WI-FI network. Thisdisclosure contemplates any suitable network and any suitablecommunication interface 2410 for it. As an example and not by way oflimitation, computer system 2400 may communicate with an ad hoc network,a personal area network (PAN), a local area network (LAN), a wide areanetwork (WAN), a metropolitan area network (MAN), or one or moreportions of the Internet or a combination of two or more of these. Oneor more portions of one or more of these networks may be wired orwireless. As an example, computer system 2400 may communicate with awireless PAN (WPAN) (such as, for example, a BLUETOOTH WPAN), a WI-FInetwork, a WI-MAX network, a cellular telephone network (such as, forexample, a Global System for Mobile Communications (GSM) network), orother suitable wireless network or a combination of two or more ofthese. Computer system 2400 may include any suitable communicationinterface 2410 for any of these networks, where appropriate.Communication interface 2410 may include one or more communicationinterfaces 2410, where appropriate. Although this disclosure describesand illustrates a particular communication interface, this disclosurecontemplates any suitable communication interface.

In particular embodiments, bus 2412 includes hardware, software, or bothcoupling components of computer system 2400 to each other. As an exampleand not by way of limitation, bus 2412 may include an AcceleratedGraphics Port (AGP) or other graphics bus, an Enhanced Industry StandardArchitecture (EISA) bus, a front-side bus (FSB), a HYPERTRANSPORT (HT)interconnect, an Industry Standard Architecture (ISA) bus, an INFINIBANDinterconnect, a low-pin-count (LPC) bus, a memory bus, a Micro ChannelArchitecture (MCA) bus, a Peripheral Component Interconnect (PCI) bus, aPCI-Express (PCIe) bus, a serial advanced technology attachment (SATA)bus, a Video Electronics Standards Association local (VLB) bus, oranother suitable bus or a combination of two or more of these. Bus 2412may include one or more buses 2412, where appropriate. Although thisdisclosure describes and illustrates a particular bus, this disclosurecontemplates any suitable bus or interconnect.

Herein, a computer-readable non-transitory storage medium or media mayinclude one or more semiconductor-based or other integrated circuits(ICs) (such, as for example, field-programmable gate arrays (FPGAs) orapplication-specific ICs (ASICs)), hard disk drives (HDDs), hybrid harddrives (HHDs), optical discs, optical disc drives (ODDs),magneto-optical discs, magneto-optical drives, floppy diskettes, floppydisk drives (FDDs), magnetic tapes, solid-state drives (SSDs),RAM-drives, SECURE DIGITAL cards or drives, any other suitablecomputer-readable non-transitory storage media, or any suitablecombination of two or more of these, where appropriate. Acomputer-readable non-transitory storage medium may be volatile,non-volatile, or a combination of volatile and non-volatile, whereappropriate.

Miscellaneous

Herein, “or” is inclusive and not exclusive, unless expressly indicatedotherwise or indicated otherwise by context. Therefore, herein, “A or B”means “A, B, or both,” unless expressly indicated otherwise or indicatedotherwise by context. Moreover, “and” is both joint and several, unlessexpressly indicated otherwise or indicated otherwise by context.Therefore, herein, “A and B” means “A and B, jointly or severally,”unless expressly indicated otherwise or indicated otherwise by context.

The scope of this disclosure encompasses all changes, substitutions,variations, alterations, and modifications to the example embodimentsdescribed or illustrated herein that a person having ordinary skill inthe art would comprehend. The scope of this disclosure is not limited tothe example embodiments described or illustrated herein. Moreover,although this disclosure describes and illustrates respectiveembodiments herein as including particular components, elements,feature, functions, operations, or steps, any of these embodiments mayinclude any combination or permutation of any of the components,elements, features, functions, operations, or steps described orillustrated anywhere herein that a person having ordinary skill in theart would comprehend. Furthermore, reference in the appended claims toan apparatus or system or a component of an apparatus or system beingadapted to, arranged to, capable of, configured to, enabled to, operableto, or operative to perform a particular function encompasses thatapparatus, system, component, whether or not it or that particularfunction is activated, turned on, or unlocked, as long as thatapparatus, system, or component is so adapted, arranged, capable,configured, enabled, operable, or operative. Additionally, although thisdisclosure describes or illustrates particular embodiments as providingparticular advantages, particular embodiments may provide none, some, orall of these advantages.

What is claimed is:
 1. A method for determining a stress level of a userbased on a sympathovagal balance (SVB) value calculated from a set ofmeasurement data, comprising: determining a heart-rate variability (HRV)characteristic as a ratio involving a number of autonomic nervous system(ANS) activity markers within a first portion of the set of measurementdata and the number of ANS activity markers within a second portion ofthe set of measurement data, and determining the stress level of theuser based on the HRV characteristic, wherein the first and secondportions of the set of measurement data are selected based on auser-specific baseline SVB value that divides a histogram representationof the set of measurement data into the first and second portions. 2.The method of claim 1, further comprising, prior to determining the HRVcharacteristic: determining a baseline SVB value based at least onuser-specific baseline data; determining the first portion of the set ofmeasurement data that is on a first side of the SVB, and processing thefirst portion of the set of measurement data to determine the number ofANS activity markers within the first portion.
 3. The method of claim 2,wherein the second portion of the set of measurement data comprises theset of measurement data less the first portion of the set of measurementdata.
 4. The method of claim 3, further comprising: processing thesecond portion of the set of measurement data to determine the number ofANS activity markers within the second portion.
 5. The method of claim1, further comprising: receiving, from a sensor of an electronic deviceof the user, the set of measurement data, and generating, based on theset of measurement data, a histogram of the ANS activity markers,wherein the histogram of the ANS activity markers is divided into thefirst and second portions such that the number of ANS activity markersin the first portion substantially equal the number of ANS activitymarkers in the second portion.
 6. The method of claim 5, wherein theuser-specific baseline SVB value corresponds to a position on thehistogram where the number of ANS activity markers in the first portionsubstantially equal the number of ANS activity markers in the secondportion.
 7. The method of claim 5, wherein the electronic devicecomprises at least a wearable electronic device, and wherein thehistogram of the ANS activity markers is determined by the wearableelectronic device.
 8. The method of claim 5, wherein the user-specificbaseline SVB value is determined by the electronic device.
 9. The methodof claim 5, wherein the stress level of the user is determined bycomparing the number of number of ANS activity markers in the firstportion with the number of ANS activity markers in the second portion.10. The method of claim 1, wherein the ANS activity markers comprise oneor more sympathetic nervous system (SNS) activity markers and one ormore parasympathetic nervous system (PSNS) activity markers.
 11. Themethod of claim 10, wherein the ANS activity markers within the firstportion of the set of measurement data comprise the one or more SNSactivity markers, and wherein the ANS activity markers within the secondportion of the set of measurement data comprise the one or more PSNSactivity markers.
 12. The method of claim 11, wherein the HRVcharacteristic is determined based on a ratio involving a number of theSNS activity markers to the a number of the PSNS activity markers. 13.The method of claim 12, wherein the HRV characteristic is determinedbased on the ratio of the number of the SNS activity markers to thenumber of the PSNS activity markers being approximately 50:50.
 14. Themethod of claim 1, wherein the ANS activity markers contribute to thefirst and second portions based on a first probabilistic weightcorresponding to the first portion and a second probabilistic weightcorresponding to the second portion.
 15. The method of claim 14, whereineach of the ANS activity markers contributes to sympathetic nervoussystem (SNS) activity based on the first probabilistic weight and toparasympathetic nervous system (PSNS) activity based on the secondprobabilistic weight.
 16. The method of claim 15, wherein theuser-specific baseline SVB value corresponds to a range of SVB values,and wherein the stress level of the user corresponds to a range ofstress-level values.
 17. The method of claim 1, further comprising:generating, based on the set of measurement data, a histogram of the ANSactivity markers, wherein the histogram of the ANS activity markers isdivided into the first and second portions, and wherein an amount ofweighted left or right shift of a histogram profile is determined basedon a weighted scaled area computation of the histogram.
 18. The methodof claim 17, wherein the amount of weighted left or right shift of thehistogram profile is determined based on an envelope characterization ofthe histogram.
 19. One or more computer-readable non-transitory storagemedia embodying software for determining a stress level of a user basedon a sympathovagal balance (SVB) value calculated from a set ofmeasurement data, that is operable when executed to: determine aheart-rate variability (HRV) characteristic as a ratio involving anumber of autonomic nervous system (ANS) activity markers within a firstportion of the set of measurement data and the number of ANS activitymarkers within a second portion of the set of measurement data, anddetermine the stress level of the user based on the HRV characteristic,wherein the first and second portions of the set of measurement data areselected based on a user-specific baseline SVB value that divides ahistogram representation of the set of measurement data into the firstand second portions.
 20. A system comprising: one or more processors;and a non-transitory memory coupled to the processors comprisinginstructions executable by the processors for determining a stress levelof a user based on a sympathovagal balance (SVB) value calculated from aset of measurement data, the processors operable when executing theinstructions to: determine a heart-rate variability (HRV) characteristicas a ratio involving a number of autonomic nervous system (ANS) activitymarkers within a first portion of the set of measurement data and thenumber of ANS activity markers within a second portion of the set ofmeasurement data, and determine the stress level of the user based onthe HRV characteristic, wherein the first and second portions of the setof measurement data are selected based on a user-specific baseline SVBvalue that divides a histogram representation of the set of measurementdata into the first and second portions.